1. 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.

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

3. 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

4. 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!!

5. 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

6. 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

7. 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

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

9. 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?

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

11. 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)

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