ACT at Duke Clinical Services
There is as much living in a moment of pain as in a moment of joy.
From suffering to liberation
Life can be painful, and it is completely natural to try to escape that pain. However, when life becomes about getting rid of unwanted thoughts and feelings, it can be less vital and less meaningful. ACT is a contemporary cognitive-behavioral therapy (CBT) that helps individuals let go of the struggle with difficult thoughts and feelings, so that they can author and pursue personal values.
There are over 300 randomized controlled trials (RCTs) testing the efficacy of ACT for an array of clinical problems. ACT is identified as an evidence-based treatment by Division 12 of the American Psychological Association (APA) and is on the empirically supported treatments list of the Substance Abuse and Mental Health Services Administration (SAMSHA).
Services we offer
We offer individual therapy for adults and adolescents. Occasionally, we have groups available. We see individuals with a variety of difficulties (e.g., anxiety, depression, other mood concerns, traumatic experiences, adjustment or stage of life issues, sexuality and gender issues, child behavior management problems, etc.). We also have unique expertise in the treatment of eating disturbances (anorexia nervosa, bulimia nervosa, orthorexia, food avoidance and phobias, binge eating), and psychological issues in the context of chronic illnesses such as type 1 diabetes.
Our program specializes in ACT and other contemporary CBTs that focus on acceptance, mindfulness, and personal values; however, we are broadly trained in evidence-based practices and can offer other specialized protocols within this framework (e.g., exposure-and-response prevention for OCD). If there is another approach that is better suited for your concerns, your provider will share this with you so that you can make an informed decision about your care.
Clinical services are provided at the Duke Clinic located at 40 Medicine Circle, Durham NC, 27710. Most insurance is accepted. Individuals who schedule an appointment may have their insurance benefits checked by a Financial Care Counselor. Treatment is provided by Dr. Merwin or other core clinical faculty and individuals under Dr. Merwin's direct supervision.
Clients participate in an initial consultation session and a treatment plan is provided at the first follow up appointment. Clients also complete self-report measures to provide additional details about their current situation and concerns. Typically, treatment is approached as a trial, with a reassessment to determine whether this approach is helpful to you. Duration of treatment can vary widely depending on the presenting concerns, and may be between 6-20 sessions.
Additional information about the program, including directions to the clinic and details about our clinical operations, fee structure and insurance can be found in the Welcome Packet.
What to expect
The basic premise of the ACT model is that problems in living arise from the way in which we interact with our internal experiences, including our thoughts, feelings and bodily sensations. Rather than observe our experiences as they unfold in the present moment, we tend to be overattached to the content of our thoughts and avoid uncomfortable thoughts/feelings. While this is completely normal and natural, it may lead us to behave in ways that ineffective for our lives or inconsistent with our personal values.
ACT uses acceptance and mindfulness strategies to free individuals to be in the present moment (with all their thoughts and feelings) and choose actions that enhance their lives. The ability to allow thoughts and feelings to be what they are, while moving in a valued direction, is the goal of ACT and referred to as psychological flexibility.
If you are working from this model, you can expect:
A therapeutic relationship that is genuine, warm and present, and based on the assumption "That which is most personal, is most general [shared]" (Carl Rogers).
Compassionate curiosity about what has or has not been working in your life.
Conversations about your personal values: who or what is important to you, and how you want to live the moments of your life.
Strategies to unhook from unhelpful thoughts and open up to painful feelings, when doing so would be life-enhancing.
Semi-structured sessions with agenda setting and home practice.
It is a "talk therapy," but sessions are experiential and often include practice in session to explore new ways of responding to thoughts and feelings, or learn new skills.
We have an active research program that aims to better understand the ways in which humans suffer and how to alleviate that suffering. Our current research focuses on life-threatening issues of type 1 diabetes management. Sometimes, we have treatment studies that you can participate in. If you participate, you may receive a free experimental treatment and provide feedback on the treatment to enhance its effectiveness. You can visit our research page to learn more.