Actions Not Words
Experiential work is core to ACT so, while the language we choose to use is itself part of therapy, we must look for every opportunity for clients to engage in experiential learning; not theory but practice.
- Breathing exercise
Some experiential work is very simple. It might just be, as you start a session, both therapist and client taking a moment to close their eyes and breathe, noticing the sensations of their seating and the physicality of their breath.
- Sensory exercise
This might involve asking a client to notice everything about their own sensory state and their surroundings when they enter a session: their mood, their breathing, their weight in the chair, the sound of the therapist’s voice. This invites them to be present, and noticing; to place attention on what’s important, not necessarily what’s in their mind.
- Noticing thoughts and feelings
At any appropriate time, clients can be invited to take a moment to notice their internal experiences, their thoughts and feelings. Here language is important once more: not, ”What are you thinking about, what are you feeling?”, but, “What thoughts and feelings can you notice? Can you label them?”
- Defusion work
Defusion is relevant to experiential work because it is the experience of getting distance from experience. We give clients practice in getting out of a fused place by adopting some distance from which to look at their experience and say, “That’s the experience I’m having.” This is as opposed to the narrow views distress can bring, such as, “This is how it is, who I am, who I will always be.” Thoughts, feelings, and sensations come and go. Can we notice them?
- Self-stories
Relatedly, and particularly for those with depression, defusion as part of experiential work allows clients to see persistent and unhelpful thoughts from a more distant perspective: as self-stories, and how they control behaviors. Hannah’s self-stories were, “I’m broken, there’s no point, I’m not going to get well, there’s something wrong with me.”
- Time travel exercise
We can ask Hannah to look into the future, asking, “If such self-stories keep deciding how you live, what does your life look like a year from now? If you sleep a lot, and don’t work or socialize, every day for a year, how does future you feel about that?” Then imagine a year spent being more active, getting a job. “What would future you say then?”
Using other versions of the self to interact with possibilities can open up narrow, distressed narratives. However, depressed clients might respond with, “But I have no choice.” So it may be an ongoing experience and process.
Looking for practical everyday tools? This print-friendly handout is just what you need. Click on the following link to download the PDF:
Experiential Work in ACT for Depression
Experiential work is a core component of acceptance and commitment therapy (ACT) for depression. This handout guides therapists in implementing various experiential interventions to facilitate practical learning opportunities for clients. Incorporate activities like breathing exercises, sensory awareness, noticing thoughts and feelings, defusion techniques, exploring self-stories, and time travel exercises in your therapy sessions. Emphasize the transient nature of experiences and help clients to develop a broader perspective on their thoughts, feelings, and self-narratives. Reflection questions prompt self-evaluation, such as assessing comfort with experiential work, adapting sensory exercises to suit client preferences, integrating additional defusion techniques, guiding clients in exploring self-stories, and ensuring understanding of the current consequences of choices. By incorporating these activities, therapists can support clients in developing greater psychological flexibility and moving toward more fulfilling lives.
Instructions
This handout guides therapists in implementing experiential interventions to enhance therapy sessions for clients with depression. Incorporate activities like the breathing exercise to promote present moment awareness. Encourage sensory engagement at the beginning of sessions to shift focus from internal thoughts to external stimuli. Prompt clients to observe and label their thoughts and feelings during appropriate moments. Introduce defusion exercises to create distance from experiences, emphasizing their transient nature. Help clients identify self-stories that influence their behaviors, and challenge rigid beliefs. Engage clients in a future-oriented exercise to reflect on the consequences of continuing with current self-stories. Emphasize practical learning and reflection. Consider client preferences when adapting the sensory exercise. Reflect on additional defusion techniques. Guide self-story exploration and challenge narratives effectively. Ensure clients understand the consequences of their choices in the time travel exercise. Incorporate these activities to support clients in developing psychological flexibility and more fulfilling lives.