The ACT for OCD Toolbox: A Guide for Therapists

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Committed Action in ACT for OCD

By Kate Morrison, Ph.D.

This presentation is an excerpt from the online courseThe ACT for OCD Toolbox: A Guide for Therapists“.

Highlights

  • Committed action describes actions that are taken toward one’s values.
  • Behavioral principles are consistent with ACT but be thoughtful in how you use them.

 

Transcript

We are now going to cover the final process of Acceptance and Commitment Therapy which is committed action.

So committed action is actually sprinkled throughout the course of treatment through the behavior tracking and goal setting that we’ve discussed before but this session that you’re going to be doing really highlights this process and really solidifies it.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

Committed action is an ACT process that describes engaging in behavior that is aligned with one’s values. Any of your behavioral principles that you already know apply here and in order to increase the likelihood of engaging in flexible patterns of behavior we want to make sure they’re driven by values rather than by fear or other internal experiences.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

At its core, ACT is a behavioral therapy and all the work that we’ve done in treatment thus far culminates in the client’s action and that is what this session is about, it’s the client’s action. We’re looking to create larger patterns of flexible behavior that is linked to their values and the reason that we focus so much on behavior is because it is changeable and controllable unlike our internal experiences like thoughts and emotions and physical sensations. So any of those behavior change techniques that you use can be included within ACT.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

As a reminder when we’re focusing on behavior change, we’re not basing it on internal experiences. We’re just focusing on how do we shift an external behavior. So some of the techniques that might be applied elsewhere but also that fit into ACT are goal setting, describing the basic principles of behavior change. Setting goals that are doable, start where the client is at or start where they are, systematically or gradually increasing and challenging themselves. So not setting goals that are completely unattainable but setting ones where they are and gradually increasing it.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

The way I say it to clients is that I want this to be challenging but doable for you and help them find that sweet spot for themselves so they’re always at their edge of challenging but doable.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

You can also make environmental adjustments, and these may be consistent with ACT but be cautious with this one about how it’s presented. If you suggest that a client stops using their computer at night in order to avoid their compulsions of researching online in the evening, make sure that it’s clear that this behavior is in line with their values and that you believe that they can use their computer whenever they choose but it may help them get to the point of being able to use their computer in the evening without compulsions if there are some restrictions set ahead of time to just block that entirely.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

You don’t want to send the message that they cannot control their behavior and they need to put limits on it through the environment and yet it can be a steppingstone to help them get to that spot where they are able to be the ones that are controlling their own behavior and that can happen within any environment.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

You often hear people talk about this in the context of alcohol use and saying, “Well, you wouldn’t ask somebody who struggles with alcohol use to go into a bar.” And what I say to clients is, “Actually, yeah, I do want that person to be able to be in a bar, be around alcohol and for them to be the ones that are in charge of their own behavior.”

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

Now, when you’re first changing your behavior, it can make it hard to do that and so you might say like, “Let’s have you avoid bars for a little while until you have the skills in place and are practiced more with these concepts so you can be in that scenario that’s probably going to be a lot harder for you than other situations might be.“

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

This is no different for a client who really struggles being at their computer at night because they are wanting to do some online research, about health conditions. Maybe initially you say, “You know what, let’s have you just not be at your computer.” And then as they are building their skills to be able to have more control over their behavior and be more open to their urges and let those pass through them rather than needing to follow what they say, then you can introduce time back with the computer and you can go about that gradually as well.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

The key points here are that committed action is an ACT process that describes actions that are taken toward one’s values. Behavioral principles and techniques apply here and are consistent with ACT but be thoughtful in your use of behavioral techniques to ensure that you’re presenting them from an ACT perspective.

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