E1142Mental Health7 Recovery and self advocacy7.1 Approaches to practice7.1.6 Acceptance and commitment therapy (ACT)Acceptance and Commitment Therapy (ACT) is the third generation of Cognitive BehaviourTherapies (CBT). ACT is part of a movement within CBT to include mindfulness as part of theapproach. “The belief behind ACT is that a more fulfilled life can be attained by overcomingnegative thoughts and feelings” (Dewane, 2008).However, rather than trying to fight a feeling that is connected with a behaviour, the solution lies inaccepting the feeling whilst still moving towards the desired outcome (Mattaini, 1997). Using theprinciples of mindfulness, the person is then able to observe this feeling, rather than identifyingwith it (Hayes & Wilson, 1994). This psychological flexibility is seen as beneficial to people in theirattempt to overcome an issue.ACT has six basic principles which work in conjunction with each other to achieve desiredoutcomes.Adapted from:www.mindtherapyclinic.com(2016).| Topic – 2 / 8© Open Colleges Pty Ltd, 2020.Cognitive defusion: thoughts and memories are simply pieces of language and images,rather than mixing cognitions with the things they refer to.Expansion and acceptance: making space for unpleasant feelings and allowing them tocome and go without struggling with them.Contact and connection with the present moment: being mindful of whatever is happeningin the moment, bringing full awareness to the here-and-now.The Observing self: experiencing thoughts and feelings and observing them, rather thanidentifying with them.Values clarification: clarifying who the person wants to be, including their deepest corevalues.Committed action: setting goals and action towards a meaningful life (Harris, 2007).One of the main aims of ACT is ‘cognitive defusion’, there are a range of techniques available topractitioners to achieve this goal. Defusion invites the person to distance themselves from theirthoughts and feelings and seeing them for what they are – streams of words and passingsensations.The key principle here is:stopstep backobserve.Observing requires a neutral stance towards the sensation, rather than interpreting it. If there isan unhelpful thought connected with the experience, it is important to identify the thought andlabel it as what is:| Topic – 3 / 8© Open Colleges Pty Ltd, 2020.an evaluation or judgementa predictiona feeling or sensationa memoryan opinionan unhelpful thinking habit:mind-reading (assuming we know what others are thinking)negative filter (only noticing the bad stuff)emotional reasoning (I feel bad so it must be bad)catastrophising (imagining the worst)the internal critic.Adapted from:getselfhelp.co.uk[http://getselfhelp.co.uk/](accessed March 2016).Once unhelpful thoughts have been identified and labelled, acceptance should come easier andallow the person to move towards a more positive and fulfilled life.Activity 44579Techniques for cognitive defusionTheCognitive Defusion (Deliteralisation)[https://contextualscience.org/cognitive_defusion_deliteralization]website provides an overview of defusion techniques, used in ACT.ACTIVITY 44579 TYPE ConsumeSCENARIO Techniques for cognitive defusion | Topic – 4 / 8© Open Colleges Pty Ltd, 2020.ACT roleplay: cognitive defusionThis roleplay shows some techniques of cognitive defusion. The counsellor is using basiccounselling skills as well as ACT.[https://youtube.com/watch?v=lz-1Jrma98Y]An unwanted guest at the partyThis cartoon is a metaphor for the key principles of ACT. Would you invite this neighbour to yourparty?| Topic – 5 / 8© Open Colleges Pty Ltd, 2020.[https://youtube.com/watch?v=VYht-guymF4]ACTIVITY 44580 TYPE ContributeSCENARIO Working with Jacob| Topic – 6 / 8© Open Colleges Pty Ltd, 2020. SELF-CHECK 44581Approaches to practiceName two key proponents of CBT.What does cognitive defusing mean? Which approach does it belong to?What does ‘externalising’ mean and which approach does it belong to?What does ‘ABC’ stand for?Name two core assumptions of the strength based approach.OARS: What does it stand for and which approach does it belong to?Name the Stages of Change?HintsThere are also other approaches which are at the verge of being considered essential to bestpractice. This includes trauma-informed practice.ACTIVITY 44581 TYPE SelfcheckSCENARIO Approaches to practice SummaryThis topic provided an overview of approaches to best practice. These approaches includemotivational interviewing, solution focused approaches, strength-based approaches, cognitivebehavioural approaches, narrative approaches, and acceptance and commitment therapy.Workers need to have an understanding of techniques of each of models in order to choosewhich technique is most appropriate for a specific consumer. It is the role of the worker toassess the individual needs and preferences of the consumer and how these approaches mightwork for them.1 2 3 4 5 6 7| Topic – 7 / 8© Open Colleges Pty Ltd, 2020.In the next topic we will learn more about best practice approaches for supporting consumersparticularly when you need to advocate for their needs and rights, introducing the concept of selfadvocacy as a key task of recovery-oriented practice.| Topic – 8 / 8© Open Colleges Pty Ltd, 2020.
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