acceptance and commitment therapy for in-school...

Running head: Acceptance and Commitment Therapy for In-School Suspension

Acceptance and Commitment Therapy for In-School Suspension: Does it Work?

A single–subject-design research project using ACT as a psycho-educational intervention

Elizabeth C. Frampton

4/16/2011West Virginia University

SOWK 618: Personal Practice AssessmentChatman Neely, MSW, LCSW, ACSW

Instructor

2Acceptance and Commitment Therapy for In-School Suspension

Abstract

The number of out-of-school suspensions (OSS) has increased dramatically over the

years in spite of warnings from the Centers for Disease Control (CDC), the American Academy

of Pediatrics (AAP), and mental health professionals of its dangers. Student misbehavior is

considered to be an indication of underlying issues which can be exacerbated by removing the

student from the school setting. Despite recommendations by the CDC and AAP that schools

implement well-structured in-school-suspension (ISS) classrooms which provide support and

psycho-educational sessions, it appears it is not an option many school systems are

implementing. This paper covers a single-system design research project evaluating the use of

Acceptance and Commitment Therapy (ACT) in a high school which is exploring the use of

structured ISS.

Introduction

Our society has long viewed adolescence as a period of rapid personal change

accompanied by great emotional upheaval, personal angst, and atrocious behavior (Adelman &

Ellen, 2002; Greco & Eifert, 2004). Current research appears to indicate that while young people

in the age group from ten to the late teens or early twenties are transitioning from childhood to

adulthood, the process is not as turbulent as previously hypothesized (Adelman & Ellen, 2002;

Greco & Eifert, 2004). Sexual, physical, and increased reasoning ability causes individuals in

this group to seek to develop a sense of individuality, and set of personal values which may or

may not be in line with those of their parents (Greco & Eifert, 2004). It may be this personal

quest for identity has caused the adolescent developmental phase to be labeled as tumultuous,

but indeed, the struggle may lie as much within the parents and social systems in which they

operate as it does with the adolescents themselves. Granted, while this life phase creates a need


for the individual to work through, and understand themselves in a social, home, and school

environment, while taking more responsibilities in those domains (Greco & Eifert, 2004), it

appears most adolescents pass through this life stage successfully (Adelman & Ellen, 2002), but

for some, the transition can be difficult.

Adelman and Ellen (2002) state adolescence pivots on four major areas: “independence,

body image, peer group and identity” (p. 72). As the individual moves through this phase, the

decision making process moves from fear of punishment, to doing what is true to the values

which are being formed. While this process is necessary and healthy, it can create conflict with

the systems in which the person functions. One arena in which this conflict plays out is the

public school system.

An adolescent’s growing need to establish his personal identity can create issues within

the very system which is geared toward preparing him for life. School safety has become a

pivotal goal within the educational system starting in the 1980’s due to rising juvenile crime, and

has become a driving issue since the 1999 Columbine tragedy (Sundius, J. & Farneth, M., 2008).

Zero tolerance has become the modus operandi within public schools, with between 79% to 94%

of public schools nationwide having established such a policy (American Academy of Pediatrics,

AAP, 2003) even though the only federal law which requires specific action is the Gun-Free

Schools Act (Sundius, J. & Farneth, M., 2008). Ninety percent of the public supports zero-

tolerance, yet the American Bar Association (ABA) voted in 2001 to end these policies, stating

they were too rigid and did not give leeway to consider the special circumstances of each

student. (AAP, 2003). The importance of school safety cannot be emphasized enough, yet in its

quest for safety, the number of out-of-school suspensions (OSS) by public schools have

increased dramatically in recent years (Dupper, Theriot, & Craun, 2009; Sundius, & Farneth,


2008). Nationally, the number of suspensions has risen from 7.1 percent for 1995-1996 to 9.0

percent in the 2006-2007 school year (Sundius, & Farneth, 2008). Dupper, Theriot, & Craun,

(2009) and Sundius, & Farneth,( 2008) agree that many times the rules governing suspension are

vague, and are for relatively minor infractions. The AAP (2003) concurs, noting in 1997, 3.1

million students were suspended, ninety per cent of which were for “nonviolent and noncriminal

acts” (p. 1207).

Sundius, and Farneth, (2008) state many suspensions are over behaviors, which in the

past, would have been viewed as immature or inappropriate, but not cause for being removed

from school. They note, in 2007, the state of Maryland had more suspensions for tardiness and

skipping school than for “dangerous substances, weapons, arson/fire/explosives, and sex offenses

combined.” (p. 5). The primary cause for suspension appears to be disrespectful behavior or

behavior which appeared to challenge teacher authority (Dupper, Theriot, & Craun, 2009;

Sundius, & Farneth, 2008). While orderly classrooms are necessary for optimal learning, the

current solution of OSS may be creating more problems than it resolves.

OSS increases the likelihood a student will ultimately drop out of school. Elkstrom, et al

(1986) noted, a student suspended during their sophomore year of high school was three times

more likely to drop out than their peers (as cited by Sundius, & Farneth, 2008). The AAP (2003)

states, missed work during the suspension period, OSS threatens a student’s ability to complete

school; something it considers quite serious since success in the area of education is considered

to be in direct correlation with health and safety. The Center for Disease Control (CDC, 1994)

notes students removed from school are more likely than their in-school peers to engage in risky

behavior, including, but not limited to, substance abuse, carrying a weapon, fighting and sexual

intercourse. The AAP (2003) maintains the position that a majority of the time behavioral


problems in students are due to depression, mental health issues, or violence in the home,

personally experienced or witnessed. One study cited by the AAP (2003) noted 15% of students

suspended the previous year had not been abused themselves, but were witnesses to domestic

violence (Kernic, et al, 2002, as cited by the AAP, 2003). Suspending these students may be

counterproductive and putting them in harms way. The AAP (2003) points out students from

single-parent households are two to four times as likely to be suspended than those who have

both parents in the home, meaning these students are less likely to be supervised while on

suspension. Isolation, lack of supervision during OSS, and the failure to receive professional

help at a time when one may need it the most, increases the chances of suicidal ideation and

behavior (AAP, 2003).

Additionally, the CDC (2001) states,

Alternatives to expulsion that will improve student behavior and school climate could be considered (250). Alternatives that retain suspended or expelled students within an educational atmosphere (e.g., alternative schools or in-school suspension) are essential to maintaining the student's connection with school and academic work (188,198). However, simply referring students to alternative educational settings is not sufficient. These programs should be of high quality and should limit the potentially harmful effects of grouping students at high risk. Effective alternative programs can support students and provide them with opportunities to learn how to manage inappropriate behaviors (188,198).

Despite recommendations for in-school-suspension (ISS) from the AAP, CDC, and other

professionals (e.g. social workers), little research has been conducted concerning the efficacy of

such a program (Dupper, Theriot, & Craun, 2009). Based on the conclusions of AAP, students

most likely to be suspended, are a vulnerable population with specific needs, yet structured ISS

has been a little explored option by most school districts. School districts which have attempted

ISS, often use it as little more than a holding pen for students (Dupper, Theriot, & Craun, 2009).

What is needed is a well-thought-out, intentional intervention during the ISS period (AAP, 2003;


CDC, 2001; Dupper, Theriot, & Craun, 2009). One of the challenges then is to find an

intervention which can be used for the limited amount of time a student may spend in ISS.

Acceptance and Commitment Therapy (ACT) may be such an intervention.

Acceptance and Commitment Therapy

ACT is a third wave therapeutic method which originates in Relational Frame Theory

(RFT); a complex theory dealing with language and cognition (Association for Contextual

Behavioral Science, ACBS; Polk, 2011). Contextual psychology stems from RFT, which is the

theory upon which ACT is based (ACBS; Polk, 2011). Third wave therapies deal with behavior

by changing a person’s relationships to their thoughts, as opposed to attempting to change

thoughts, as Cognitive Behavior Therapy which is second wave, or by behavior modification

which is considered first wave (O’Brian, Larson, and Murell, 2008). ACT’s basic premise is that

suffering comes because a person becomes overly attached to certain thoughts (fusion) or is

continually judging thoughts as good or bad (a function of language). This fusion causes

inflexibility in the way a person functions (O’Brian, Larson, and Murell, 2008). ACT uses

mindfulness and acceptance as part of the therapeutic process. There are a multitude of attempts

to define mindfulness. I define it as observing, here and now, what is happening externally and

internally.

ACT addresses six areas: “Self as Context, Defusion, Acceptance, Contact with the

present moment, Values, and Committed Action (Hayes, et al, 2006, p. 8). O’Brian, Larson, and

Murell, (2008) maintain the first four of these areas deal with mindfulness. Unlike CBT which

challenges and attempts to change negative thoughts, ACT promotes acceptance of one’s

thoughts with non-judgmental observation, and assessing if the thoughts are moving one in the

direction of their values. Hayes, et al., (2005) states the focus of ACT is to help a client identify


and clarify his values so that he can choose actions which promote, or move him in his desired

life direction. Often a person becomes enmeshed in certain ideas which create a barrier to

moving forward toward values (cognitive fusion), or because of previous life experience,

embrace certain self-defeating ideas about himself, which ACT calls “Attachment to the

Conceptualized Self” (p. 6). Since certain thoughts or memories are painful, and because an

individual may project painful memories into the future, assuming pain will occur again,

experiential avoidance (EA) occurs. In order to stop painful internal experience, a client may

engage in self-defeating behaviors such as substance abuse, anger, or any number of behavioral

issues.

The use of mindfulness in ACT is to develop a sense of oneself as an observer to

thoughts; to recognize thoughts as simply a function of the mind, and not necessarily indicators

of truth or reality. By being in contact with the present moment, while accepting thoughts as just

thoughts, one can choose actions which move them in the direction of their values, instead of

becoming bogged down with the idea, all thoughts are true. The process of developing

mindfulness is achieved by using metaphors or exercises in a therapy session, which begin to

point out how thoughts come and go as one moves through daily routines. As a client becomes

an observer of his thoughts, he can begin to develop psychological flexibility, and not act on a

thought which does not move him in the direction of his values. This process is called defusion

(Hayes, et al, 2005, O’Brian, Larson, and Murell, 2008). This approach is another way in which

third wave therapies differ from second wave; the emphasis is more on how thoughts occur, the

process, as opposed to the content of thoughts (Coyne, Cheron, and Ehrenreich, 2008). The idea

is not to change thoughts, but to change one’s relationship to their thoughts (Hayes, et al, 2005;

Coyne, Cheron, and Ehrenreich, 2008). The ultimate goal of ACT is to develop this mindfulness


and acceptance of thoughts, so the client is free to choose actions based on his values, rather than

simply behaving in way which is an attempt to avoid painful thoughts, memories, or anticipated

pain (Coyne, Cheron, and Ehrenreich, 2008).

Coyne, Cheron, and Ehrenreich (2008) state ACT has been shown, empirically, to be

effective in working with adults. Due to the complexity of its concepts, the use of ACT with

adolescents and children has been questioned, and research in this area is relatively new and

growing. O’Brien, Larson, and Murrell, (2008), assert the distress suffered by children and

adolescents is not that different from adults, yet consideration must be given to the position they

hold in society and their environment. Due to their status as minors, O’Brien, Larson, and

Murrell (2008) encourage full participation in the ACT process for not only the clients, but by

the school and family systems as well, a stance the AAP (2003) and CDC (2001) promote as

well. A discussion which would include an environmental treatment falls outside of the

parameters of this paper.

Growing research indicates ACT is effective in the treatment of adolescents when the

treatment is geared toward the developmental stage of the client (O’Brien, Larson, and Murrell,

2008). O’Brien, Larson and Murrell (2008) state between the ages of nine to fifteen, a youth is

able to think abstractly, so the concepts of ACT should not create difficulties, and in fact, they

believe ACT is suited for child or adolescent clients because of its use of “experiential exercises

and metaphor” (p. 19).

Hypothesis

Since ACT has been shown to be effective in the treatment of some adolescent issues, in

particular with youth at risk of dropping out of school (Moore, et al, 2003 as cited by O’Brien,

Larson and Murrell, 2008) it is proposed the use of ACT in an ISS-ALC will give students


insights into the way their behaviors move them toward or away from their values, helping them

to think about behavior choices.

The Setting

My research project took place in Riverside High School, located in Kanawha County,

West Virginia. This school is engaging in a pilot study regarding ISS, and uses an Alternate

Learning Center (ALC) during school hours in lieu of suspension for certain school rule

infractions. The ALC at Riverside is a structured classroom with a full time teacher, to my

knowledge the only structured ISS classroom in the state, although this ISS classroom structure

is recommended by the AAP and CDC. At times during the research period I would ask students

what they thought about being in the ALC classroom and, interestingly, often students would

state it has been a positive experience. They reported the structure of the classroom gave them

the opportunity to catch up on school work, or to think about their actions. These comments were

made at the beginning of the group.

Kanawha County schools has in place a rating system with regards to student

misbehavior. A listing of infractions and subsequent referral to ALC can be found in Appendix

2. Christopher Cantrell, Vice Principal at Riverside, states there are some gray areas with

regards to rule infractions, and part of his job is to assess the appropriate action to take, while

taking into consideration the individual student (Personal interview, March, 2011). More

information concerning the structure of the ALC is contained in Appendix 3 of this paper.

Riverside High School has partnered with Cabin Creek Health Systems (CCHS) to

improve the content of the ALC classroom. Previously, ALC was essentially a holding room for

referred students, but in recent years a full time teacher has been employed to provide a

structured, consistent setting for these students and CCHS is now offering psycho-educational


sessions for students in the classroom. One of these psycho-educational sessions is an ACT-

based group (Farley, letter to Board of Education, April 10, 2010). This research project

evaluates the efficacy of the ACT psycho-educational session in the school’s ALC.

ACT Session Structure in ALC

Psycho-educational sessions conducted in the ALC are based on a matrix grid developed

by Kevin Polk, Ph.D. (Farley, letter to Board of Education, April 10, 2010)( Handouts used

during the process are included in Appendix 4). The process involves talking to the students

about their experience in the world. They observe through the five senses, and then the brain

creates thoughts or interpretations about what has been taken in through the senses. The brain

also retains memories which have been interpreted as positive or negative. The manner in which

sensory input is interpreted or remembered can create an emotional response within the

individual, which can impact the body. Positive interpretations or memories are pleasant and

may cause a person to smile, feel happy, and relaxed. Negative interpretations of sensory input or

a negative memory may cause the student to experience emotional upset with ensuing tension in

the body, creating headaches, stomach difficulties, or other issues.

The students are given a copy of the matrix and it is also used on a SMART board or a

dry erase board. Exercises are used to help the students notice how the brain is always thinking.

Sometimes they are asked to close their eyes, and not think about anything for five minutes. This

request is usually followed by comments from the students saying it is not possible to do.

Students are asked to identify someone who has influenced them, and if comment is made the

influential person loves me, they are asked to identify what the person does to show their love.

The emphasis is on the fact, no one can know the inner standards a person holds unless

actions are congruent with those values. Students are asked to identify their values, and what


actions they can take to move them in the direction of these inner principles. They are asked to

identify internal feelings, thoughts, or conditions which may create a barrier in moving toward

valued living. Barriers may include anger, depression, anxiety, or fear; conditions which are

unpleasant, and the students may try to avoid by engaging behaviors such alcohol, drug abuse, or

physical altercations, etc. These behaviors are identified by the students. The session emphasis is

to encourage students to move in the direction of their values, in spite of unpleasant thoughts or

feelings. Thoughts are just thoughts, and do not have to be a barrier to moving in a valued

direction.

The Process

Since ACT covers various aspects of thought and behavior, the challenge was deciding

what characteristic of the intervention to measure. The psycho-educational interventions are brief

(one hour), and students may be seen only once during the research period. Measuring change in

behavior was not practical, since there are not ongoing sessions with the same students, or follow

up. There was a need to keep the measurement tool brief, due to the length of time during a

session, and to maximize response; a long questionnaire would have been perceived as annoying

to this population.

Given that one of the facets of ACT is thoughts, I chose to create a measurement tool

which focused on what effect the session had on the way students thoughts or perceptions of

thoughts may have changed during the session. Questions as to whether they considered the

session to be helpful, the clarity of the session, and presenter apparent trustworthiness were

included as well. Six questions used a Likert scale, with two qualitative questions about what

was enjoyed the most, and least during the group; creating a questionnaire limited to one page in

length with eight questions. This particular project called for a brief, simple, measurement tool


which could be administered without resistance by the population. I choose wording which

would “speak” to high school students, and attempted to measure an aspect of the intervention

which could be assessed after one session, without follow up. I also included an option for the

students to identify themselves as male or female, simply to see if there was any measurable

difference in the responses. A sample of the evaluation questionnaire can be found in Appendix

1.

Results

The evaluations were collected over a seven week period, with forty-five students

participating in the psycho-educational ACT sessions and completing evaluations. I led the

sessions for six of the weeks, with the instructor who trained me in ACT, filling in for me one

week when I could not be present. Initially, I had not planned on collecting evaluations the week

I was not to be in the classroom, but later decided to see if there would be a difference in student

response if the session was taught by a different individual. There was no significant difference

in student response.

Eighteen students identified themselves as female, twenty-one as male. Four students

chose to not identify their gender on the evaluation, while two checked both male and female.


Responses to the evaluation by question follow:


Females appear less ambivalent in their responses than males.


Due to the brief nature of the intervention, my hopes were to, at least, cause the students

to think about ways they could do things differently in their lives. Question 4 touches on the

minimum target, with a positive on questions 5 or 6, considered to be above expected results. I

considered questions 4-6 to be a progression, but was surprised when the progression did not

always pan out, with some 4’s being negative on student evaluations, but with 5 or 6 being

positive. It is possible the students were indicating they were not just thinking in general, but

thinking specifically, or planning on change. The charts show the number represented

graphically above.

Questions #1 #2 #3 #4 #5 #6Strongly Agree 16 32 25 12 5 7Sort of Agree 23 12 12 16 20 12No Opinion 5 7 15 16 17Sort of Disagree 1 3 5Strongly Disagree 1 1 2 1 4Number of students per assessment answer.

Questions #1 #2 #3 #4 #5 #6Strongly Agree 36% 71% 56% 27% 11% 16%Sort of Agree 51% 27% 27% 36% 44% 27%No Opinion 11% 16% 33% 36% 38%Sort of Disagree 2% 7% 11%Strongly Disagree 2% 2% 4% 2% 9%

Total 100% 100% 100% 100% 100% 100%Assessment Answers by %

Forty five students participated in the groups; eighty-seven percent of whom thought the

group was helpful to some extent. Ninety-eight percent felt the presentation was clear, with

eighty-three percent stating the presenter seemed to be trustworthy. Question 3 was included in

an attempt to evaluate the ability of the presenter to establish rapport with the students. It was

also postulated the information would be received with more openness if the presenter was

perceived as one who can be trusted. Sixty-three percent (28 students) indicated the group helped


them to think about ways they could do things differently in life, 55% (25 students) saying they

were thinking about changes they could make, and 43% (19 students) stating they were going to

make changes as a result of the group. If neutral answers are not considered to be negative, but

rather an expression of the ambivalence often experienced by adolescents, the efficacy of the

intervention is outstanding; of course, “no opinion” might mean a lack of buy-in to the concepts

as well. A time extended research project which involved follow up with the students could shed

light on the meaning on the “No Opinion” and all responses. The quantitative portion of the

assessment indicates the use of an ACT-based intervention makes an impact on student thinking

for a majority of the students participating, influencing students to think about life choices in the

future, and leading some to work toward behavior change immediately.

Qualitative Portion of Assessment and Discussion

The assessment included two qualitative questions: “What did you enjoy the most about

the presentation?”(Question 7) and, “What did you enjoy the least?”(Question 8). Four students

out of forty-five (9%) did not answer the qualitative portion of the assessment.

The challenge when working with adolescents is the life stage through which they are

passing. They may be wrestling with life choices, how to respond to authority, and how to learn

to function in the world. This concept may be especially true with students in ALC, who, as

pointed out by the AAP, are possibly struggling with issues beyond normal adolescent; therefore,

the qualitative portion on this assessment yielded a wide variety of responses. Additionally, a

few students added a qualitative comment on the quantitative portion of the form. An example of

which was made by a student who answered “neutral” for question 4, but then wrote in that he

was doing fine, indicating he did not need to think of things differently. An initial response to

such a statement may be cynicism or the thought the student was in some type of denial, yet a


conversation with the ALC teacher (private conversation), shed a different light on the matter.

On that particular day some students were present because their teacher lost control of the

classroom and sent the entire class to ALC. As a result, one of the people in the session was one

of the top performing students in the school, with a GPA of over 4.0.

On the other hand, there were students in the classroom who appeared to have severe

issues. One student was removed by the teacher when he began screaming and yelling after I told

him to “chill” after making an inappropriate sexual comment to me. Other students sat with their

heads down and answered questions so quietly it was difficult to hear them, some of the

qualitative answers that day stated they did not like hearing about depression during the session.

Some answers challenged what may be a general attitude that misbehaving students just do not

care; one male answered he did not like hearing about suffering, because he did not like to see

people suffer.

All of the responses to these questions were recorded and then reviewed for themes, and

while some comments such as, having to sit, listen, or even being present in ALC could be

expected, two major themes arose from the qualitative portion. Themes to which I will refer to as

Values and Voice. It may come as a surprise to some people that one portion of the presentation

the ALC students liked the most was hearing about, talking about, participating in exercises

which focus on values. Additionally, several students indicated they enjoyed the entire

presentation, a majority of which focuses on values, even when they did not specifically mention

values. Twenty-one students (47%) stated there was nothing about the presentation they did not

like.

Another dominating theme of the qualitative portion of the assessment, can be

encapsulated in an answer given by one student to question 7, “Just the fact she listened.” It is a


theme I will label as “Voice.” In various ways students stated they enjoyed having someone

come into the classroom who seemed to notice them; someone who would take time out of the

day and come into the classroom, allowing them to express thoughts, discuss ideas, get to know

them, allowing them to get to know each other, who listened when they talked, and helped them

to look at life in a different way; they were given a voice, they were noticed, and treated with

respect. One of the more interesting responses to question 7 was “I felt opened.” It lead the

researcher to conclude a majority of these students do not feel heard or noticed. Sometimes

during the sessions, I would make a statement about feeling invisible; a statement which would

often draw nods from the group. The qualitative portion of the assessment revealed it was

powerful for students to have a time when they were noticed and respected.

Conclusions

This single-subject research project supports other literature which promotes the use of

ACT with adolescents. O’Brien, Larson, and Murrell (2008) maintain the concepts of ACT

should not be difficult for adolescents to comprehend. Responses to Question 2 indicates all

students, with the exception of one, believed the presenter to be clear in the concepts being

taught. Occasionally, a student would ask for clarification about a word or term, but there was no

indication during the session the students did not understand the concepts of ACT. The ACT

emphasis on values was well received by the group, as were other aspects of the intervention; the

noticing of thoughts, realizing thoughts are just thoughts, to name a few.

The challenge in this setting is the time frame, and lack of follow up. A more in-depth

project could track student behavior from the session on to see the impact on behavior.

Additionally, ACT covers so many aspects of human behavior, a one hour session is inadequate

to fully work with a vulnerable population group. Due to lack of time, it may be too much


information is trying to be conveyed, and a few students commented the session seemed long. If

an intervention could be spread out over a two to three weeks time frame, with the same

students, there would be more time to engage in more of the experiential exercises ACT

employs, which could impact the efficacy of the intervention.

One portion of the project which bears consideration is the setting itself. It is entirely

possible a similar intervention in an unstructured ISS would not have the same impact as

Riverside’s ALC. The structure of the school’s ALC may be creating a mindset which helps the

students to be more receptive to the intervention. The ALC teacher states there are occasions in

which a student’s grades will improve while they are in ALC (ESMH Conference, April 12,

2011). A statement in line with student comments.

Recommendations

During the course of the research it became apparent ISS classrooms are not always used

in a manner which would benefit students. A conversation with one health care professional

indicated Riverside was the only school in the state which is providing a structured ISS

classroom with a full time teacher (personal communication, April, 2011). How ISS is used on a

national level is unknown; however, research seemed to indicate many schools use ISS as a

holding pen for students, without structure or intervention, making it a stop on the way to OSS

(Dupper, Matthew and Craun, 2009), as opposed to an opportunity to intervene with a vulnerable

population. Further exploration into structured ISS classrooms is highly recommended. It should

be noted, O’Brien, Larson, and Murrell (2008) propose, if ACT is being used with adolescents, it

should also be incorporated into the environment in which the adolescents function (e.g. school

and family). The presence of highly successful students in the ALC during the research period,

indicate there may be a benefit to integrate ACT into faculty training as well.


The combined results of the quantitative and qualitative portions of the assessment,

indicate ACT can be used effectively with adolescents in a structured ISS setting. Students

appreciated exploring values and barriers which may prevent them from moving in their valued

life direction. The intervention’s use of exercises which emphasis the ability to choose actions

congruent with values appeared to impact a majority of the students. Further research which

follows up with students could give more insight to the long term effects of an ACT intervention.


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suspension_20080123/whitepaper2_20080919

Appendix 1


ACT Evaluation Gender(optional) Male___Female___

1. I found this presentation helpful:

Strongly agree Sort of agree No opinion Sort of disagree Strongly disagree

2. I thought the presenter was clear in what she was trying teach.


3. The presenter seemed like someone I could trust.


4. The group helped me to think about ways I could do things differently in my life.


5. I’m thinking about some changes I could make in my life because of this group.


6. I expect to make changes in my life as a result of this group.


7. What did you enjoy the most about the presentation?

8. What did you enjoy the least?

Thank you for your participation. If you think you would like to schedule an appointment to talk

to someone about concerns you have in your life, please put your name on this evaluation.


Appendix 2


Appendix 3


Appendix 4

acceptance and commitment therapy for in-school...

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