The ACT for OCD Toolbox: A Guide for Therapists

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The ACT Advisor 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

  • The ACT Advisor assesses where your clients are on each of the 6 ACT processes.
  • It can be administered as a self-report or on your own as a therapist.

 

Transcript

Now, we’re going to focus on the ACT Advisor which is a tool that can help you assess where your client is on each of the 6 ACT processes.

And this is something that can be done as a self-report, so having your client fill it out on their own, or you can administer it as the therapist just on your own without the client. And I find that I use this in different ways depending on the client and depending on different points in therapy.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

For example, I complete this on my own at the beginning of therapy and this means that this is something that I would look at when I’m assessing which areas to focus on with my client. But it’s not something that I’m going to ask them to be looking at at the beginning of therapy, especially because these aren’t going to be concepts that we have covered with them yet, and they may not have a full understanding of what they are being asked. And then later in therapy, it’s something that I might do with the client, and we’ll talk about that in a minute.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

So, the ACT Advisor just to orient you to what this looks like, it is a hexagon that has kind of a lower side or the center of the hexagon and then on the higher side of each of these processes is the larger part of the hexagon. In each point of the hexagon, so this is also called the hexaflex, there are questions related to each of the ACT processes.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And so, as you’ll see and we’re going to walk through each of these that it’s asking clients to rate themselves or for you to rate the clients on each of the processes and whether they are high or low on these. You know, the ACT Advisor has a scale for each of those, so from 1 to 10 where you would rank this person on where they’re at for that particular process.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

Now, I don’t typically go about this with the precision of the numbers 1 to 10. There is a scoring system, and you can get a percentage at the end of this. But I tend to not do that partially because the utility for me I find it’s more that I want to know if the person is high, low, or moderate and that’s really the level of precision that I think I need when I’m looking at this.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

The other reason I don’t tend to do this, the exact numbers, is because of the population with whom I work and I’m primarily working with clients who experience perfectionism. They are people that tend to be wanting to do therapy right and then that can lead to them maybe wanting to rate themselves higher on this or give themselves a good grade and I don’t find that that’s necessarily something that’s very useful for the client.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And so, if that’s something that a client is really struggling with, it probably would not be a client that I would show the ACT Advisor and that’s not something I would do in session with them because it might give them the message that they’re either doing good or bad in therapy depending on where they’re at. So, it might be just something that you want to consider in understanding whether you want to do this with a client or on your own.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

But like I said, you can use low, high, medium as ways that you can have the client describe where they feel they’re at on each of these processes as well. And so, I think you have some flexibility, and it really depends on your therapy style as well if you want to be completely upfront about these specific processes or if you want to just have that be something that you’re doing behind the scenes. I find that I do both just depending on the types of clients that I’m working with and how they might respond to it.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

So, let’s start with the acceptance scale. Low on acceptance is described as, “I constantly struggle with my thoughts and feelings”, and high on acceptance might sound something like, “I willingly accept my thoughts and feelings even when I don’t like them.” And those are examples of high and low acceptance and so that helps anchor where you would put the client for this particular process.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

Let’s next go to the defusion scale. One to 10, 1 being, “My thoughts tell me how things really are and determine what I do next,” high being, “I see each of my thoughts as just one of many ways to think about things. What I do next is up to me.” So, you can hear both in there, the deliteralization as well as the separation of behavior and thoughts, as parts of defusion.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

The self-as-observer is assessing the self-as-context process, and low on this is, “Deep down my thoughts and feelings are the real me,” high on this is, “My thoughts and feelings come and go, but deep down the real me doesn’t change.”

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

The Commitment in Taking Action Scale is, you can guess from the name, it’s focusing on the committed action process in ACT. Low is, “I don’t manage to act on the things I care about,” and high is, “I work out what I need to do about the things I care about, and I see it through.” This is really focusing on the behavior. Like do you actually do the things that are important to you.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And then values. Low on this is, “I don’t know what I want from life,” so low on understanding what’s important. High on this is, “I am clear about what I choose to value in life.” So again, for this one, we’re focusing just on, do they know what is important to them? And this is regardless of whether they’re taking action on that or not, because that is going to get captured in the committed action part of the scale.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And then lastly, Attention to the Present Scale, this is assessing the present moment process. Low on this is, “I spend most of my time lost in thought about the past or future.” High on this is, “I spend most of my time paying attention to what is happening in the present moment.”

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

As you can see, walking through this either on your own or with a client, it’s something that’s going to help you understand where they’re at on these processes. And to be honest, this is what I’m doing in my head all throughout working with someone when I am using ACT because this is assessment to determine where they’re at with each of these processes.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And then from there, when someone is lower on one of those, that can be a sign that that’s where you need to do some more work. Then you can choose which techniques, which aspects of ACT that you want to be using with the person so you can help them grow on that particular scale.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

Now, this is for your information as well as if you share this with the client. I share with people that I don’t expect any human being to be a 10 with all of these all the time. What we’re looking for here is to understand when they are lower on these what can they do in order to help themselves grow or where they’re getting stuck in therapy.

References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

And so, this is something that can be really useful if you find that you’re not seeing progress for someone or maybe at the end of treatment you’re wanting to see what just needs some extra work. It can also be done as — If somebody is coming back in for booster sessions, this can help you see where they are at so you can know what to do next as far as your intervention goes. So, you can see that this is an iterative process of assessing and intervening.
 
References

Chantry, D. (n.d.). ACT ADVISOR Psychological Flexibility Measure. Retrieved from https://contextualscience.org/act_advisor_psychological_flexibility_measure

Okay. The key points here at that the ACT Advisor is a tool that can help assess where your clients are on each of the 6 ACT processes, and it can be administered as a self-report or on your own as a therapist. You go through each of the processes to assess where they are and that can then inform the intervention that you’re using with the client.

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