PTSD and Commitments: Obstacles
Booz Allen
Department of Veterans Affairs
Yale University
University of Nevada, Reno
Key Points
- Client barriers to following through with committed action are inevitable.
- There are external environmental barriers and internal barriers.
- Conduct a functional analysis of the barriers to help break them down and move forward.
Materials Downloads
Transcript

There’s no perfect world where everything falls into place as soon as the client makes a series of commitments. In fact, rarely is an initial commitment made and completed without some sort of struggle, barrier, or delay arising. This is a natural part of the process and the therapist should expect barriers and obstacles to arise.

It can be useful to inoculate the client from this experience by proactively bringing up the topic of barriers and obstacles as soon as commitments are made. This will open the door for the therapist to be able to work on addressing any obstacles that arose when the client returns to session and reports that they were unsuccessful with completing their commitment. These barriers can arise in response to any of the processes that we’ve discussed previously that lead to psychological inflexibility.
Moran, D. J., Bach, P. A., & Batten, S. V. (2018). Committed action in practice: A clinician’s guide to assessing, planning, and supporting change in your client. New Harbinger Publications.

So here are some sample obstacles to committed action on the part of the client. They may come back and say, “Well, I know I committed to that, but I didn’t feel like it.” So that’s experiential avoidance. They had the thought that they knew they were supposed to do that. They checked their feelings and didn’t feel like it. They didn’t have the feeling that they wanted, that they thought they should have, that would need to be there in order to do what they needed to do. And they didn’t want to feel the way they would feel when they did the action. “So, I didn’t feel like it.” So, that’s avoidance.
Moran, D. J., Bach, P. A., & Batten, S. V. (2018). Committed action in practice: A clinician’s guide to assessing, planning, and supporting change in your client. New Harbinger Publications.