Table 1 An outline of the ACT sessions, together with associated metaphors, experiential exercises and home practice
Session | Main focus of the session (with metaphors and/or experiential exercises) | Home practice |
|---|---|---|
1 | Aim: Assessment of current issues, goals of therapy and introduction to ACT Exercises: Introducing ACT Online supplemental material: Introducing ACT audio file | 1) Notice the things that are important and matter to you and the thoughts, feelings and sensations that get in the way of this |
2-7a | ACT process: Values Aim: Clarify what is important and matters to you (i.e. what you want to be doing and how you want to be doing that) Exercises: Centering exercise; Lifetime achievement award, Values List or Values Questions; Life compass Online supplemental material: Small steps exercise audio file | 1) Notice the thoughts, feelings and sensations that get in the way of the things that are important and matter to you, and what you do when they show up 2) Take the smallest step that would move you towards one of your values |
ACT process: Acceptance Aim: Explore workability of emotional control strategies and introduce an alternative to emotional control Exercises: Centering exercise; Passengers on the bus; Accepting all of you or Physicalising exercise Online supplemental material: Willingness exercise audio file | 1) Notice the thoughts, feelings and sensations that you would have to be willing to have in order to move towards the things that are important and matter to you 2) Take the smallest step that would move you towards one of your values | |
ACT process: Defusion and contact with the present moment Aim: Practice skills for unhooking from thoughts, feelings and sensations in order to move towards the things that are important and matter to you Exercises: Centering exercise; "I notice I'm having…”, Singing the thought or saying it in a silly voice, Writing the thought in different colours/different styles/reverse order, “Milk, milk, milk” or Imagine a thought on a computer screen; Notice 5 things or Tracking your thoughts in time Online supplemental material: Leaves on a stream audio file | 1) Practice unhooking yourself or stepping back from your thoughts, feelings and sensations in order to move towards the things that are important and that matter to you 2) Take the smallest step that would move you towards one of your values | |
ACT process: Self-as-context Aim: Practice skills for noticing the distinction between you and your thoughts, feelings and sensations in order to move towards the things that are important and matter to you Exercises: Centering exercise; Labels exercise, Very brief self-as-observer and/or House/furniture metaphor Online supplemental material: Connecting with the noticing you audio file | 1) Practice looking at your thoughts, feelings and sensations, including the stories that you tell about yourself, in a different way, from a different viewpoint in order to move towards the things that are important and matter to you 2) Take the smallest step that would move you towards one of your values | |
ACT process: Committed action Aim: Explore external barriers and ways of overcoming them using selection, optimisation and compensation principles Exercises: Centering exercise; Part 1 of willingness and action plan incorporating selection, optimisation and compensation principles Online supplemental material: Your kind friend audio file | 1) “Find another route around external barriers” in order that you can continue moving towards the things that are important and matter to you 2) Take the smallest step that would move you towards one of your values | |
ACT process: Committed action Aim: Set goals and actions in service of values Exercises: Centering exercise; Part 2 of willingness and action plan incorporating selection, optimisation and compensation principles Online supplemental material: Problem solving for external problems | 1) Set and publicly commit to completing your goals and steps in service of your values 2) Take the smallest step that would move you towards one of your values | |
8 | Aim: Review skills and concepts discussed and the metaphors and/or exercises used to illustrate them; review gains made in the sessions; and explore ways of more effectively handling thoughts, feelings and sensations in the future Exercises: Centering exercise Online supplemental material: Hexaflexercise audio file | N/A |