Acceptance & Commitment Therapy for depression

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1 Acceptance & Commitment Therapy for depression combining mindfulness and behavioural psychology to promote effective living Dr. David Gillanders, University of Edinburgh

2 Overview The historical and conceptual roots of ACT An overview of the model An ACT approach to mindfulness Application to depression Conceptual aspects of the relationship between ACT and other therapies

3 A history lesson Behaviourism as a rejection of introspection Flavours of behaviourism Radical behaviourism = everything is behaviour Sensibilities of humanism, Buddhism,

4 The ACT model Is not a mind model Is a model of 6 interdependent and overlapping behavioural processes that help us to answer: What is influencing behaviour in this moment?

5 The ACT model ACT is a therapy approach that uses Acceptance & Mindfulness processes and Commitment and Behaviour Change processes to produce greater psychological flexibility Hayes et. al., 2004

6 The ACT model Psychological flexibility is the ability to contact the present moment more fully as a conscious human being and to either change behaviour or persist, when doing so serves valued ends. Wilson & Murrell, 2005

7 The ACT model: Psychological Inflexibility Dominance of Past & Future Experiential avoidance Cognitive Fusion Psychological inflexibility Attachment to the self story Lack of clarity or contact with Values Inaction, impulsivity or avoidant persistence

8 The ACT model: Psychological Flexibility Contact with the present moment Willingness / Acceptance Cognitive Defusion Psychological Flexibility Clarity and contact with Personal Values Committed Actions towards Values Flexible Perspective Taking on our Stories

9 Focus on workability Much less interested in causes of depression More interested in how people respond to depression Conceptualises the responses people make as strategies for living

10 Focus on workability Validating, compassionate stance: you are not broken Are the strategies you are using working? Letting go of strategies that don t work and finding other strategies

11 Focus on values What do you most care about? If you were free to choose. Overarching life directions Specific steps linked to directions

12 Mindfulness and acceptance Use of mindfulness, defusion and willingness to behave flexibly when obstacles arise To change or persist

13 Depression Lack of pleasure / low motivation: unhooking feelings as reasons for action Pessimism and self criticism: unhooking thoughts as reasons for action Rumination: identifying verbal problem solving as an unworkable strategy

14 Depression Holding our stories more lightly Specific commitments: to self, others, freely chosen. Connection to values is part of the work

15 ACT & CBT Trees Pines Oaks

16 ACT & CBT Family of cognitive and behavioural therapies Cognitive Therapy Acceptance & Commitment Therapy

17 ACT & CBT Family of cognitive and behavioural therapies Cognitive Therapy MBCT Acceptance & Commitment Therapy

18 ACT & CBT Family of cognitive and behavioural therapies MBCT Acceptance & Cognitive Behavioural Commitment Therapy Activation Therapy

19 ACT & Other Therapies Techniques & Interventions Techniques & Interventions Concepts & Theory Concepts & Theory Philosophical Assumptions Philosophical Assumptions

20 Further reading Dr Russ Harris, (2007), Constable Robinson, available on Amazon Also: Behavior Therapy Special Series, Edited by David M. Fresco: Theories and Directions in Behavior Therapy: ACT and Contemporary CBT, Vol. 44, Issue 2, pp [June 2013]

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