ACT Case Conceptualization: Assessing the 6 Core Processes

By DJ Moran, PhD

This presentation is an excerpt from the online course “Demystifying ACT: A Practical Guide for Therapists“.

Highlights

  • Case conceptualization includes: information regarding the client’s problem, the past situations that shaped the person’s problem, the current situations that maintain this problem, the short- and long-term therapy goals and developing an evidence-based treatment plan.
  • It is important to learn to do this if you want to be an effective therapist.

 

Transcript

Thank you so much for joining me for this training. I’m DJ Moran and we’ll be talking about case conceptualization in Acceptance and Commitment Therapy.
I think case conceptualization is an important skill for therapists and counselors to learn to do well if they want to have significant influence on their clients. My friend, Patty Bach, and I wrote a book called “ACT in Practice: Case Conceptualization in Acceptance and Commitment Therapy.” In this training, we will discuss some of the ideas from that book.

Case conceptualization is an integration of assessment data focused on the client’s clinically relevant behaviors, the information regarding the historical and current environment that influence those behaviors, the mutually developed treatment goals and the planned therapeutic process to be used to approach those goals.
Case conceptualization is in part a creative process of the clinician and it is also guided by evidence-based principles.

Case conceptualization includes information regarding the client’s problem, the past situations that shaped the person’s problem, the current situations that maintain this problem and usually talk about short- and long-term goals for therapy and then we use all of that material to develop an empirically supported or evidence-based treatment plan.

Case conceptualization has also been called case formulation and working hypothesis in the literature. Throughout this training, these terms may be used interchangeably for style purposes but I will primarily use case conceptualization for consistency.

In ACT case conceptualization, the assessment tracks the six processes of the ACT approach – defusion, acceptance, self as context, values, contact with the present moment and committed action – and assists the therapist in facilitating greater psychological flexibility for the client. Now, if you’re unfamiliar with these six ideas, please know that they are essential concepts in one perspective of the ACT model and you would do well to go back to other trainings that discuss those six concepts.

Now, case conceptualization is important. Luoma, Hayes and Walser 2007 suggest that ACT case conceptualization “leads to a more focused, consistent and thorough intervention.” If that’s something that’s important to you as a counselor or as an applied behavioral scientist, then learning case conceptualization is a good idea. In other literature written by Berman 1997, this scientist says that in general terms, case conceptualization elucidates “what the client is like as well as theoretical hypothesis for why the client is like this.” Beyond the hypothesizing of the clinically relevant what and why, it is incumbent upon the clinician to conceptualize treatment goals such as the where the client is going and how to best get there.

The key points for this module are that case conceptualization includes information regarding the client’s problem, the past situations that shaped the person’s problem, the current situations that maintain this problem, the short- and long-term therapy goals and developing an evidence-based treatment plan.
Another main point is that it is important to learn to do this if you want to be an effective therapist.

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