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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

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act ii specific examples from an act trial

ACT II:Specific Examples from an ACT Trial

Jon Abramowitz, Laura Fabricant, & Ryan Jacoby

Clinical Lunch Spring 2014

overview
Overview
  • ACT principles
  • Our study on exposure therapy and ACT
  • Techniques to foster acceptance
  • Techniques to foster defusion
  • Techniques to pursue values
  • Discussion (applying ACT to other problems)
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I spend most of my time paying attention to what is happening in the present moment

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ATTENTION TO PRESENT SCALE

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

I am clear about what I choose to value in life

ACCEPTANCE SCALE

I spend

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

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I constantly struggle with my thoughts and feelings

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I don’t know what I want from life

VALUES IDENTIFICATION SCALE

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

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

DEFUSION

SCALE

Deep down, my thoughts and feelings are the real me

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

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

I see it through

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COMMITMENT & TAKING ACTION SCALE

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SELF AS OBSERVER SCALE

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

our study
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
acceptance
Acceptance
  • Willingness to experience internal events
  • Examples from OCD patients
  • Metaphors and techniques
    • “Jerk at the door”
    • Chessboard
    • Exposure
      • Habituation vs. fear tolerance
defusion
Defusion
  • Distancing and disconnecting from thoughts
  • Seeing thoughts and feelings for what they are, not what they say they are
  • Examples from OCD patients
  • Metaphors and techniques
    • Milk, Milk, Milk
    • Passengers on the bus
    • Imaginal exposure
passengers on the bus metaphor
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
Values
  • Choosing what direction one wants life to take (not letting OCD choose the direction life goes)
  • Examples from OCD patients
  • Metaphors and techniques
    • Bull's-eye
    • Moving through a swamp
    • Exposure
slide12

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
Moving through a swamp
  • Swamp = OCD-related inner experiences and triggers
  • Exposure = learning how to handle whatever comes up while still moving forward through swamp
  • Willingness 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
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
discussion1
Discussion
  • How could we apply these techniques to other problems?
  • Similarities and differences with other therapies?
  • Questions?