Acceptance Acceptance and and

CommitmenCommitmentt

Therapy Therapy (ACT)(ACT)

Group WorkGroup Workwith Adolescentswith Adolescents

Shane CurleyShane Curley

The ACT ‘Hexaflex’The ACT ‘Hexaflex’

ResourcesResources•Greco and Hayes - Acceptance and Greco and Hayes - Acceptance and

Mindfulness Treatments for Children Mindfulness Treatments for Children and Adolescents and Adolescents

•Louise Hayes, Joseph Ciarrochi and Louise Hayes, Joseph Ciarrochi and Ann Bailey, forthcoming self-help Ann Bailey, forthcoming self-help book for teenagers - Get Out Of Your book for teenagers - Get Out Of Your mind And Into Your Life For Teensmind And Into Your Life For Teens

Youth Gone Wild!Youth Gone Wild!

What do we know or presume What do we know or presume about young people?about young people?

• Family and peer relationships are top of Family and peer relationships are top of the list the list

• Prefrontal cortex not fully developedPrefrontal cortex not fully developed• Reward centre is more active than adultsReward centre is more active than adults• What do we see:What do we see:

– Low attention spanLow attention span– Difficulties with intense emotionsDifficulties with intense emotions

So keep it all asSo keep it all as fun, brief and concrete fun, brief and concrete as as possiblepossible

Group workGroup workIt’s like making a movieIt’s like making a movie

And you usually stuff it up the first timeAnd you usually stuff it up the first time

Ubiquitous Human Suffering & Ubiquitous Human Suffering & Creative HopelessnessCreative Hopelessness

• Introduce these concepts via a fun Introduce these concepts via a fun collection of video clips, paused at collection of video clips, paused at sections for debrief and sharing.sections for debrief and sharing.

Watch DVDWatch DVD

Get to VALUES as soon as Get to VALUES as soon as possible, values based action is possible, values based action is

the keythe key•Generally speaking most groups could be Generally speaking most groups could be

split into two categories:split into two categories:•Those that readily explore values and find this a Those that readily explore values and find this a

significant intervention on its ownsignificant intervention on its own•Those that find it difficult to explore their values. Those that find it difficult to explore their values.

Where you find values you find suffering. Where you find values you find suffering. • But its still important to go there early and But its still important to go there early and

provide additional support where necessaryprovide additional support where necessary• Revisit this often and introduce Committed Revisit this often and introduce Committed

Action as soon as it’s appropriate. Action as soon as it’s appropriate. $10 Million Exercise or Two Sides of the Coin$10 Million Exercise or Two Sides of the Coin

Mindfulness & Self As Mindfulness & Self As ContextContext• Introduce it in progressive stages, for example:Introduce it in progressive stages, for example:

– Begin with simple eyes open breathing exercises ‘breath Begin with simple eyes open breathing exercises ‘breath into your stomach like it’s a balloon’into your stomach like it’s a balloon’

– Then eyes open five senses experiences ‘notice five Then eyes open five senses experiences ‘notice five sounds you can hear’sounds you can hear’

– Mindful eatingMindful eating– Progress finally to the most difficult, eyes closed Progress finally to the most difficult, eyes closed

‘thought watching’‘thought watching’– Add SAC components – Weather Metaphor, Body as a Add SAC components – Weather Metaphor, Body as a

House.House.

• Get with the group, keep pace with themGet with the group, keep pace with them• Use language that they identify with, especially if Use language that they identify with, especially if

they generate it:they generate it:– High, Medium and Low energy exercises. High, Medium and Low energy exercises. – A client said after a ‘thought watching’ exercise, ‘I saw A client said after a ‘thought watching’ exercise, ‘I saw

an ipod with songs going past on random, so I just let an ipod with songs going past on random, so I just let them come and go’.them come and go’.

– Getting in the ‘Zone’ Getting in the ‘Zone’ Watch brief videoWatch brief video

Defusion & AcceptanceDefusion & Acceptance

Use terms the group generatesUse terms the group generates

Exercises to introduce what you mean Exercises to introduce what you mean by 'thoughts', don’t presume everyone by 'thoughts', don’t presume everyone uses words the same. uses words the same. Example: ‘5 senses Example: ‘5 senses experience’ and ‘notice your feet’ exercises.experience’ and ‘notice your feet’ exercises.

The essence of RFT is arbitrarily applicable derived relational responding that isnon-arbitrarily applied. Relational responding refers to the ability torespond to relations between stimulirather than just responding to each stimulusseparately. Relations between stimuli can

bederived (from the processes of mutual andcombinatorial entailment)

For every new ACT For every new ACT process…process…• Combine it with a fun activity: Combine it with a fun activity: Burning building Burning building

(acceptance), golf (defusion), building a bridge (values), (acceptance), golf (defusion), building a bridge (values), mindfully eating lunch in the park, team building exercises like mindfully eating lunch in the park, team building exercises like toxic swamp and the human knot (defusion and acceptance).toxic swamp and the human knot (defusion and acceptance).

Be realistic, don’t try to do too Be realistic, don’t try to do too much!much!

However, here are additional components However, here are additional components I’ve experimented with:I’ve experimented with:

• Connecting with family each weekConnecting with family each week• Text messaging the task for the weekText messaging the task for the week• Creative ways to record the main ‘take Creative ways to record the main ‘take

home message’ – the art from this home message’ – the art from this presentation comes from thispresentation comes from this

• Filming exit interviewsFilming exit interviews• DVD for each participant of individual DVD for each participant of individual

interview, weekly white board work, fun interview, weekly white board work, fun photos and video of the activities photos and video of the activities