Metaphors in ACT for OCD: The Sunset
Key Points
- Begin session 3 with a review of the home practice.
- Use session 3 to continue the concept of willingness.
- Introduce other willingness practices and metaphors.
- Normalize any fears or hesitations about this practice.
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Transcript

We’re going to start on session 3. And session 3 is meant to continue on with the concept of willingness, to practice it and to begin making behavioral commitments.

You can begin the session by reviewing their homework, and this will help you assess where they’re at with this process. You can ask about their ease or lack of ease with it, what they noticed, what went well, what didn’t. You want to elicit information from them that will help you know where to focus during this session.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.,Twohig, M. P., Hayes, S. C., & Masuda, A. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior Therapy, 37(1), 3–13.,Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705–716.

As you’re looking through their homework, you can say, “Oh, I noticed in your willingness diary, you had a mix of openness to the obsessions and also trying to get rid of them. That’s great because then we can look at the differences there. What did you notice when you tried responding to them differently?” Or you can say, “Oh, I see you practiced picturing your friends as a thought or your thoughts as a friend. How did that go?”
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.,Twohig, M. P., Hayes, S. C., & Masuda, A. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior Therapy, 37(1), 3–13.,Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705–716.
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