Using ACT Briefly in Powerful Ways: An Interview with Patricia Robinson, PhD
What is the biggest mistake that clinicians make in terms of using their time effectively with brief visits?
All clinicians rely on training they received early on in their careers. Unfortunately, there is sometimes a poor fit between that early training and the work context that the trained professional enters. Many work contexts require a clinician to work briefly and to engage patients that are minimally motivated to participate in lengthy and complex treatments. When a clinician continues to rely on practice habits developed for delivery of services that require more of a time investment from the patient, the clinician’s effectiveness and relatedly their level of satisfaction with work is limited. Understanding the patient’s preferences concerning time helps the clinician made adjustments to practice patterns and better engage a wider variety of patients.
Primary care is the first place people often get help with psychological issues. What do PCPs need to serve their patients’ mental health better?
PCPs need behavioral health partners with a broad range of skills, and who know how to work within a team. Behavioral health clinicians who learn to work as consultants to PCPs and patients can assist the PCP with improving medical and psychological health for people of all ages with all sorts of life challenges. PCPs also need to learn more about assessments and interventions that help patients improve functioning. A teammate with behavioral health expertise can provide this type of instruction during the course of delivering care to patients on a daily basis.
What is Focused ACT, in a nutshell?
Focused ACT (fACT) is ACT that’s uber patient-centric. It focuses on the problem of greatest concern to the patient and shines a light on the patient’s efforts to address it. Often, patient efforts work in the short-term but may take the patient off the track of pursuing a vital life in the long-term. Gradually, patients become stuck in unworkable behavior patterns that have a negative impact on their daily lives. In fACT, the clinician uses brief contextual assessment and practical conceptualization tools to build a strong foundation for radical change. All fACT visits conclude with the development of a behavioral experiment. The goal of fACT work is to create behavioral variability and to enhance the patient’s ability to learn from their direct experience.
How have you seen it work effectively with patients firsthand in a medical setting?
Many patients benefit from a single visit with a fACT trained clinician. This is possible in part because the approach that I recommend addresses the problem of patient access. Clinicians using fACT in a medical setting offer same-day access to patients. The optimal time to help a patient enhance psychological flexibility is when they are hurting the most and requesting help. Whether a patient is suffering with medical or psychological problems—or both, receiving same-day service from a clinician trained to identify and build upon the patient’s strengths and support their vitality is a powerful and meaningful change experience.
Patricia Robinson, PhD, is a practicing psychologist and expert in the clinical use of mindfulness, acceptance, and value-driven living. She is co-author of the best-selling book, The Mindfulness and Acceptance Workbook for Depression and other influential books such as Brief Interventions for Radical Change, and Real Behavior Change in Primary Care.