Download Brief Interventions for Radical Change: Principles and Practice of Focused Acceptance and Commitment Therapy PDF

TitleBrief Interventions for Radical Change: Principles and Practice of Focused Acceptance and Commitment Therapy
File Size1.9 MB
Total Pages297
Table of Contents
Part 1
	Principles of Brief Intervention
Chapter 1
	A Brief Review of Brief Therapy
Chapter 2
	How People Get Stuck
Chapter 3
	The Process of Radical Change
Part 2
	Practice Tools and Methods for Brief, Focused Interventions
Chapter 4
	Focused Interviewing
Chapter 5
	Strategies and Tools for Increasing Motivation
Chapter 6
	Promoting Radical Change
Part 3
	Case Examples
Chapter 7
	Big Like Swallow: FACT with an Abused Child
Chapter 8
	Lost in Space: FACT with Drug and Alcohol Problems
Chapter 9
	Playing It Safe: FACT with an Adult Survivor of Sexual Abuse
Chapter 10
	Disconnected and Demoralized: FACT with a Depressed Elderly Woman
Part 4
	FACT with Couples and Groups
Chapter 11
	Until Death Do Us Part: FACT with Couples
Chapter 12
	The More the Merrier: FACT in Groups
	Interview, Case Formulation, and Assessment Tools
Document Text Contents
Page 2

“This book is a must-read not only for ACT therapists with an interest in
brief therapy, but for any ACT therapist who wants to improve their
efficiency and effectiveness with the model. Low on theory and high on
practicality, this book is choc-a-bloc full of new tools and techniques for
brief but powerful ACT interventions. You’ll be amazed at how simple
and easy it makes the trickier aspects of ACT, such as self-as-context and
creative hopelessness. If you want to get better results in less time with
more clients, then you need to read this book right now!”

—Russ Harris, author of The Happiness Trap

“If you are looking for a rapid way to help people reduce their suffering
and make positive changes, this book can show you the way. The four
questions Strosahl, Robinson, and Gustavsson provide can give you a
quick handle both on what’s going on with clients and on how to help
them change. A nice variation on the ACT method with some new
insights and additions to make it compatible with clients’ and third-party
payers’ demands for efficient and effective treatment.”

—Bill O’Hanlon, author of Change 101, A Brief Guide to Brief
Therapy, and The Change Your Life Book

“Brief therapy alert: This book is valuable reading for anyone interested
in time-sensitive ‘brief’ therapy. It provides theory, methodology, research
evidence, and numerous clinical examples for how to help clients rapidly
make significant changes. It is also an excellent introduction to the larger
field of acceptance and commitment therapy, offering concepts and
techniques that clinicians can adapt to their own practices. Strongly

—Michael F. Hoyt, PhD, author of Brief Psychotherapies and
Interviews with Brief Therapy

Page 148

Big Like Swallow: FACT with a Sexually Abused Child


Setting the Stage for Radical
Change: What Kind of Life
Would You Choose?
The previous four focusing questions have set the stage for radical behav-
ior change. Freddy has readily agreed with the idea that some of his
efforts to solve his problems aren’t helping and are, in fact, limiting his
ability to do something he values: make friends. Seeking to elicit an opti-
mistic response, the clinician frames the question about life direction in
terms of a world where anything is possible.

Clinician: Freddy, in a world where anything is possible, what would
you be doing in life right now?

Freddy: Going to school, playing with friends…being good at math.

Clinician: And?

Freddy: Maybe getting to do stuff with my mom and stepdad.

Clinician: And?

Freddy: Maybe I could make up computer games and draw pictures of
creatures for the games.

Clinician: Okay, being good at math would help you develop games,
and having friends would help you know what kind of games
to invent— what kids would like to play.

Freddy: Yep.

Page 149

Brief Interventions for Radical Change


Choosing Direction: Life Path
and Turnaround Exercise
The clinician uses the Life Path and Turnaround Exercise to help Freddy
reframe his problem and identify more effective ways to deal with his
hurt feelings and buildup of negative emotions (see Figure 6). Freddy
describes his desired life direction, one with more meaning, as growing
like the Swallow character in his video game. It also included making
friends, learning math, going to school, and having fun with his parents.
He sees himself as traveling mostly in the direction of more control,
trying to protect himself from hurt feelings and from having future prob-
lems with exploding. The clinician suggests that it might be possible for
Freddy to learn skills for working with his head being full and for protect-
ing himself so that he could have these problems and still go to school to
learn and make friends. Freddy doesn’t know how he can motivate
himself to move toward more meaning, but he wants to hear the clini-
cian’s ideas about this. He sees his parents and his grandmother as poten-
tially helpful to him.

Page 296

and, 46, 119–125; openness and, 45,
113–119; three pillars illustration, 45

public behaviors, 101, 102

questions: focusing, 70–80, 265–266;

pre-group orientation, 250–251;
skillful use of, 63–64

radical change process, 49–65; adult
survivors of sexual abuse and, 187;
childhood sexual abuse victims and,
139; depressed elderly clients and,
209–211; setting the stage for,
80–82; substance-abusing adults
and, 162–163

rating scales, 272
reframing problems, 82–83
rehabilitation phase, 16
relational frame theory (RFT), 32–33
relationship counseling. See couples

therapy case example
remediation phase, 16
remoralization phase, 16
reorienting interventions, 120–121
resistance, encouraging, 19
retirement party exercise, 120
revolving-door problem, 16
river analogy, 55–56
role modeling, 62
rule following, 40–41, 54, 87
rule-governed behavior, 34–35
rumination, 101
Say It Slowly intervention, 198
Scales of Choice intervention, 174–177
schizophrenia, double bind theory of, 20
scripts, cognitive-affective, 37
self: distinguishing from mind, 114; Little

Self, Big Self intervention, 145–148;
observing, 30–31

self-narrative, 36, 109–110
self-reflexivity, 35
sense making, 36

serendipity, 60
sessions. See therapy sessions
sexual abuse case examples: adult

survivor of sexual abuse, 180–201;
childhood victim of sexual abuse,

short-term changes, 243
short-term therapy, 12
single-session therapy, 14
small behavior change, 60
social labeling, 51
social skills training, 153
sociocultural context, 30
solution talk, 21
solution-focused brief therapy (SFBT), 4,

21–22, 24
speaker-listener relationships, 115
speech: rule following indicated by, 87.

See also language
sticky thoughts, 114
storytelling, 109–111
stress, coping with, 51–52
substance abuse: addictive behaviors and,

177–178; challenges to treating,
155–156; pointers on using FACT
for, 177–178

Substance Abuse and Mental Health
Services Administration

substance-abusing adult case example,
156–177; awareness-promoting
intervention, 169–171; case
formulation process, 166–167;
engagement-promoting intervention,
173–177; focusing questions,
157–161; life direction exercise,
163–165; openness-promoting
intervention, 171–173; radical
change discussion, 162–163;
treatment summary, 168–177

suffering: behavioral rigidity and, 44;
FACT technique for describing, 255;
language related to, 28–29

Page 297

symptoms: biomedical approach to, 51,
53; FACT orientation to, 51–53;
treatments focused on eliminating,

therapists: relationship of clients to,

61–64; role modeling provided by,

therapy: evidence for rapid responses to,
17–18; myths and misconceptions
about, 13–18

therapy sessions: avoidance behavior in,
86–87; client assessments in, 272;
importance of first, 58

thoughts: RFT view of, 32–33; sticky, 114
time-effective treatment, 12
time-limited therapy, 12
To Love and Protect intervention, 150
toys, using with children, 153
treatment summary: adult survivor of

sexual abuse case example,
193–200; childhood sexual abuse
victim case example, 144–152;
couples therapy case example,
236–241; depressed elderly client
case example, 215–224; substance-
abusing adult case example, 168–177

True North Exercise, 94–98, 266, 269;
adult survivor of sexual abuse case
example, 188–190; substance-
abusing adult case example, 163–165

type 1 vs. type 2 change, 20–21
Uncommon Therapy (Haley), 19
valued life: committed action and, 122;

connecting clients to, 80–82;
contacting values for, 120–121;
couples therapy related to, 242, 243;
developing engagement in, 119–125;
group therapy exercise on, 256–257;
life direction exercises and, 90–98,

verbal avoidance, 87
verbal self-knowledge, 18

walking your life path exercise, 256
Watzlawick, Paul, 20
Weakland, John, 20
website for book, 104, 253, 265
“what” questions, 64; “what are you

seeking?,” 71–73; “what has it cost
you?,” 77–79; “what have you tried?,”

“when” questions, 64
White, Michael, 22
“why” questions, 64
willingness, 63, 122
Wilson, Kelly, 32
wise mind, 41–42, 43
word machine analogy, 32
Words of Wisdom intervention, 224
workability examination, 100–103, 267,

271; of client strategies, 75–77; of
private behaviors, 101–103; of public
behaviors, 101, 102

worksheets: Flexibility Profile Worksheet,
98–103, 270; Four Square Tool, 102,
103, 267, 271; Life Path and
Turnaround Worksheet, 92, 141,
266, 268; True North Worksheet,
97, 266, 269


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