Acceptance- and mindfulness- based interventions - 2 Source: Farmer, R. F., & Chapman, A. L. (2008). Behavioral interventions in cognitive-behavioral therapy: Practical guidance for putting theory into action. Washington, DC: APA.

Change vs. Acceptance and Mindfulness ? Exposure therapy aims to change the individuals’ relationship with and reactions to experiences

When to use Acceptance- and Mindfulness-Based Interventions? 1) Justified vs. unjustified reactions Example: realistic fears 2) Changeability vs. unchangeability Past trauma, abuse, death… 3) Effectiveness vs. ineffectiveness

Balancing Acceptance- and Change- Based Methods! Linehan’s DBT model – dialectic tension You don’t want to be invalidating to a client who suffers from a severe trauma – you know the event can’t be changed, emotion is justified… change is for skill building, but validation for the emotions. For suicidal – validate but also change!!

Mechanisms of Change: Acceptance and Mindfulness Interventions Increasing the client’s repertoire of responses to aversive situations Exposure, response prevention, counterconditioning (pairing an aversive conditioned stimulus with a pleasant response), and extinction

Mechanisms of Change: Mindfulness Interventions Increasing contact with a broader array of stimulus Positive and negative reinforcement Mindfully attending to present without reacting to it – eliminating/extinguishing problematic behaviors while adaptive responses are reinforced Biological changes: research on meditation

Accepting Strategies for the Client Letting go of the struggle for control (letting go of the need to control the undesired, unacceptable experience) “creative hopelessness” (Hayes et al., 1999) Defusing language and cognitions (ACT; Hayes et al., 1999) Repeating a troublesome word or phrase until it becomes meaningless Willingness vs. willfulness (application: p. 269) Radical acceptance

Acceptance within Dyadic Relationships Examples: emphathetic joining, unified detachment …

Accepting Strategies for the Therapist: Validation Expressing interest Accurate reflections Stating the unsaid Validating in view of background history Validating in view of current circumstances WHEN WOULD YOU NEED THESE THE MOST?

VALIDATION DOES NOT MEAN “NO CHANGE IS CALLED FOR!” think of changeable and ineffective emotional responses!

Examples of Mindfulness-Based Interventions Mindfulness-based stress reduction (Kabatt-Zinn, 1990) Acceptance and Commitment Therapy (ACT; Hayes et al., 1999) Dialectical Behavior Therapy (DBT; Linehan, 1993) Mindfulness-Based Cognitive Therapy (MBCT; Teasdale et al., 2000)

A mindfulness skill: Observing without judging! Observing the thinking Observing breathing Observing physical sensations Observing urges Observing sights, sounds, smells, tastes, and tactile sensations