In and Out of Session
So in session, we’re choosing and modeling language to encourage more helpful thinking and behaviors. We’re using metaphors and experiential exercises to get people present, noticing their thoughts and feelings instead of being driven and tyrannized by them. But practice outside of session is at least as important.
Clients must often be reminded that life won’t change if they don’t do things differently. What we often see, and this was true of Hannah, is clients saying, “I’m depressed and don’t want to be. Hey, therapist, please fix that for me. But I don’t want to do anything differently myself.” This is a very stuck place for both client and therapist to be, if the client doesn’t do work between sessions, if only on tiny things.
Mindful Awareness
Hannah was thus asked to practice mindful awareness daily, increasing over time from a minute a day to two minutes; to download a meditation app; and to practice mindful walking. She loves animals, and also practiced mindfulness of her cats and her brother’s dog, really looking at their eyes and touching them. There are many mindfulness exercises online, but again, a client will find more resonance when there’s a personal connection.
Journaling
Being a writer was an important value for Hannah, so keeping a journal was a way to help her connect with that while seeing her thoughts written out, creating a distancing effect. It was still hard to get her to do it, however.
Other Work
Hannah was asked to practice a variety of other activities outside sessions, texting her therapist about successes.
- Requesting support from friends
- Connecting with friends
- Moving her body a little more
- Going dancing
- Cleaning her room
- Traveling to see her siblings, which she was afraid to do, thinking she was too fragile. But it actually ended up being important, hanging out with them and their friends, and seeing how adult life might look and feel.
Writing to a “Friend”
Additionally, Hannah was set other writing exercises. For example, she was asked to write a letter to an imaginary friend, who was given a name. The “friend” was struggling with the same difficulties as Hannah, whose letter provided advice, support, and compassion. This was an elaborate version of the what-would-you-tell-a-friend question, which of course told Hannah some things about herself.
Looking for practical everyday tools? This print-friendly handout is just what you need. Click on the following link to download the PDF:
Setting Homework Using the ACT Perspective
This handout guides therapists in setting homework assignments from an acceptance and commitment therapy (ACT) perspective. While therapy sessions focus on modeling helpful thinking and behaviors, it is equally important for clients to practice outside of sessions to facilitate change in their lives. Address the common challenge of clients expecting the therapist to fix everything without making any personal effort. Emphasize the need for clients to engage in work between sessions, even if it’s starting with small tasks. Practical homework assignments can include practicing mindful awareness daily, journaling to gain a different perspective, engaging in activities aligned with their values, seeking support from friends, and writing a letter to an imaginary friend. Reinforce the key points of mindful awareness, journaling, seeking support and connection, and the importance of taking action and making small changes. Homework assignments are an integral part of the therapeutic process in ACT, allowing clients to actively work toward their treatment goals and experience meaningful life changes.
Instructions
This handout guides therapists in setting homework assignments from an ACT perspective. While therapy sessions focus on modeling helpful thinking and behaviors, it is essential to emphasize the importance of practice outside of sessions. Remind clients that change requires an active effort on their part. One practical assignment is daily mindful awareness practice, starting with one minute and gradually increasing to two. Encourage journaling for gaining a different perspective on thoughts and emotions. Assign activities aligned with client values, such as seeking support, connecting with friends, engaging in physical activities, trying new experiences, and tidying living spaces. Additionally, suggest that your client writes a letter to an imaginary friend experiencing similar difficulties, providing support while gaining self-insights. Emphasize the significance of taking action and making small changes for treatment progress. These homework assignments, rooted in the ACT perspective, support the journeys of clients toward meaningful life changes.