DUMC Box 3842

Duke Clinics, 40 Duke Medicine Circle

3rd Floor, Purple Zone, Suite 3700
Durham, NC 27710
Tel: 919-681-7231

© 2014 by ACT at Duke 

  • Twitter Clean
  • Facebook Clean
  • YouTube Clean

Phone: 919-681-7231

Committed Action Exercises

LIST OF EXERCISES

If you know what you are looking for, click on the link below to be taken directly to the exercise. Otherwise, explore this lists of exercises we have compiled for fun!

 

 

Identifying being "on-track" versus "off-track in session

Identifying being 'On-Track' versus 'Off-Track' in session

Submitted by Russ Harris

I use this a lot with clients who tend to keep derailing the session. It’s incredibly powerful, and it trains defusion, acceptance, contact with the present moment, and committed action all in one simple intervention. (I wanted to put it into ACT Made Simple, but there was no space –so here it is in print for the first time).

To use this strategy, first, you need to agree that you and the client are a team - working together for a specific goal. (Obviously if the client’s goal is to get rid of their anxiety, you can’t agree to that – you just declare your helplessness; admit you don’t know how to do it in any manner that enriches life; and offer them the alternative: to ‘learn how to handle anxiety more effectively so it has less influence and impact over you’.)
So in this case you and the client might agree the goal is to have ‘more successful social interactions’, or to ‘learn how to handle anxiety more effectively so it has less influence and impact over you’, or to ‘increase social life’ etc.


Okay, that’s step one: agree on a goal, and agree you’re a team.

Step two: you say, ‘Now here’s my prediction. I could be wrong, but i predict that throughout this session, every time we start to really knuckle on down to achieving this goal, your mind is going to try and derail us; to pull us off track. And what I’d like for us to do, if you’re willing, is to identify all the different tactics your mind uses to do this; so we can spot them when they show up, and make sure we don’t get derailed by them. Is that okay?’

Step three: Therapist pulls out a large sheet of paper and a pen.
T: ‘So I’m going to write down here every tactic your mind uses. I’ll start off writing for the first few tactics, and then I’ll pass the paper over to you, and you can take over, okay?’


C: Okay
T: So what’s your mind saying now about this?
C: It won’t work.
T: Okay. Let me jot that down. ‘It won’t work’. (As the therapist says it aloud, he also writes down: ‘It won’t work’). What else?
C: This is bullshit.
T: Okay. ‘This is bullshit.’ (As the therapist says it aloud, he also writes down: ‘This is bullshit.’) What else?
C: I don’t see how this will help me.
T: Okay. ‘I don’t see how this will help me.’ (As the therapist says it aloud, he also writes down: ‘I don’t see how this will help me.’) What else?

After writing down five or six ‘derailing tactics’ - such as, ‘this is weird’, ‘but nothing has ever worked in the past’, ‘I won’t be able to do it’, - the therapist hands the paper and pen to the client.

T: So what I’d like you to do, if you’re willing, is each time your mind comes up with one of these tactics to pull us off track, just put a tick by it, so we can see how many times it shows up. Okay? And if your mind comes up with a new tactic I’ll get you to write it down, add it to the list, okay?
C: Well I can do that, but I don’t see how it’s going to help.
T: Okay, now you’ve already got that one on the list, right there: ‘I don’t see how this will help me’ – so can you place a tick by it?
(Client ticks the statement on the list)
T: See how quickly that one showed up? I bet it’s gonna come back at least another 3 or 4 times this session. Any others showing up?
C: Yeah, this is bullshit.
T: And that’s there too, isn’t it? So put a tick next to that one.
(Client ticks the statement on the list)
T: Any others showing up?
C: Yes. (smiling a little – ticks two of the other statements on the list)

As the session continues, every time the client tries to move away from the goal, the therapist calls it out as a derailing tactic and asks the client to write it down. Most clients have a repertoire of about five to fifteen tactics, and the others they come up with are just variants on these basics. At some point, the therapist is likely to need to have the following conversation:

T: Okay, so now let’s get back to that goal we agreed on.
C: There’s no point. It won’t work.
T: Is that one on the list?
C: Yes. (ticks it) But it’s true! It really won’t work!
T: Well, here’s the thing – I can’t guarantee you that it will work. In fact if you ever visit any professional who guarantees you that their treatment will work, I suggest you don’t go back to them, because they’re either bullshitting you or they’re deluded. Go to the world’s greatest surgeon for an operation and she will not guarantee you a successful outcome; she will ask you to sign a consent form in which you acknowledge all the things that could possibly go wrong. So I could show you lots and lots and lots of research on ACT to prove how effective it is with depression, anxiety, addiction, schizophrenia, you name it ... but that wouldn’t guarantee it will work for you. So here’s what I DO guarantee: I guarantee I will do my very best to help you, using the skills and knowledge that I have. I also guarantee, that if we stop the session because your mind says it won’t work, then I will be of no help to you whatsoever. So here we are – your mind is saying this won’t work – shall we let it say that and carry on, or shall we stop the session?
C: Carry on.
T: Great. So can you write down the words ‘But it really is true’ just there on your sheet, in front of ‘This won’t work’ – and put another tick by that thought, and let’s get back to the goal.

The beautiful thing about the ‘off-track, on-track’ strategy is that you are training defusion, acceptance, contact with the present moment, and committed action without even mentioning that this is what you are doing, and with minimal psycho-education – you’re just right into it. Plus, it helps the therapist defuse and stay on track.