By DJ Moran, PhD
This presentation is an excerpt from the online course “Demystifying ACT: A Practical Guide for Therapists“.
- Solid ACT case conceptualization needs to have a perspective of the concerns that lead to inflexibility.
- There are six converse dyads that we should look at.
- Acceptance: Experiential avoidance
- Defusion: Cognitive fusion
- Self as context: Attachment to the conceptualized self.
- Committed action: Persistent inaction, impulsivity or avoidance.
- Values: Unclear values or domination by pliance, tracking and augmenting.
- Contact with the present moment: Dominating concept of the past or the future and weak self-knowledge.
In the last part of the Acceptance and Commitment Therapy case conceptualization training, I discussed how the assessment tracks the six processes of the ACT approach – defusion, acceptance, self as context, values, contact with the present moment and committed action – in order to assist the counselor in facilitating greater psychological flexibility for the client.
And the counselor also has to look out for where the client is lacking in these six areas of flexibility. So part of the training in case conceptualization is learning what is on the other side of the spectrum of a flexible repertoire. Each of the six points of the ACT hexagon model has a converse and we can look at the six points on the model called the Inflexahex. This is the hexagon model that shows what psychological processes can lead to inflexibility, thus the name Inflexahex.
When a client is having trouble with accepting, we call that experiential avoidance. The converse of defusion is when the client is engaged in cognitive fusion. Having an ability to contact the self as context can actually assist psychological flexibility. And if there is rigidity around this, we would call that attachment to the conceptualized self. Committed action occurs with psychologically flexible repertoires and we see clinical struggle with persistent inaction, impulsivity or avoidance. Having clearly authored values contributes to psychological flexibility and lacking clarified values or being dominated by pliance, tracking or problematic augmenting can be a clinical concern. Finally, a psychologically flexible repertoire is contacting the present moment, whereas inflexibility gets fostered by weak self-knowledge or a dominating concept of the past or the future.
We can put all of these clinically relevant inflexible concerns on a similar hexagon model and we call it the Inflexahex.
Patty Bach and I developed a worksheet for the Inflexahex for clinicians to use for taking notes. As you work with your client, when they say something that shows to contribute to their problematic inflexibility, you can write that down on the worksheet in the domain related to their inflexibility. During the treatment or after the session when you’re doing your case conceptualization, you can use this filled out Inflexahex worksheet to really get a sense of what the client is struggling with from an ACT point of view and begin to develop your treatment plan off of these data. As we move forward, we will spend time on each one of these six dyads and get a chance to explore the concerns that lead to inflexibility. This is critical for case conceptualization.
There are some key points to this video.
Solid ACT case conceptualization needs to have a perspective of the concerns that lead to inflexibility and there are six converse dyads that we should look at.
The other side of the spectrum of acceptance is experiential avoidance. The other side of the spectrum for defusion is cognitive fusion. Self as context has the other side of the spectrum being the attachment to the conceptualized self.
The clinical concern that impedes committed action, well that’s persistent inaction, impulsivity or avoidance.
Values clarification has a converse of unclear values or domination by pliance, tracking and augmenting. And the other side of the spectrum of contact with the present moment is dominating concept of the past or the future and weak self-knowledge.
More ACT presentations
- Acceptance: A Core Process in the ACT Hexagon Model
- ACT Case Conceptualization: Assessing the 6 Core Processes
- An Introduction to the Introduction to ACT
- Contact With the Present Moment: A Core Process in the ACT Hexaflex Model
- Defusion: A Core Process in the ACT Hexagon Model
- Self-As-Context: A Core Process in the ACT Hexagon Model
- The Inflexahex Model in ACT: Acceptance vs Experiential Avoidance
- The Journey of Life: A Metaphor for Values in ACT
- Values and Committed Actions in ACT
- The Hockey Goalie: A Metaphor for Psychological Flexibility
- ACT and Mindfulness: Understanding The Relationship
- ACT Is an Empirically-Supported Therapy: Background and Clinical Evidence
- ACT and Psychological Flexibility: Why It Matters, Examples and Definitions