By Patti Robinson, PhD, and Kirk Strosahl, PhD
A surprising approach for better results
When people think of progress in mental health contexts, they often picture a lengthy process.
They imagine a straight line from illness to health, rising steadily with each consecutive session until you finally reach transformation months or years later.
From this perspective, one or two sessions might not seem like enough time to change a person’s life.
Not by a long shot.
But actually, change isn’t as linear as we might think.
Many practitioners of acceptance and commitment therapy (ACT) have seen this in their own work. They’ve been able to help a client overcome panic attacks, loosen the grip of an eating disorder, or otherwise change their entire life in just a small amount of time — even a single appointment.
These kinds of quick transformations aren’t rare.
In fact, the data shows that improvement most often jumps up quickly in the first few sessions and then levels off relatively early in therapy (typically by session eight).
Even further, clients who receive brief treatments experience relatively high rates of rapid change when compared with those in longer therapy…
And since rapid response is linked to long-term success and decreased risk of relapse, this brings us to an exciting conclusion:
We can achieve better outcomes specifically by condensing treatment.
Not only can life-altering change happen in just a few sessions — it’s actually more likely to lead to long-term success than treatment that’s drawn out over dozens of visits.
Paired with the fact that about 30% of clients don’t come back after the first session (and of those who do, most will stop coming to therapy by the fifth session), this gives us a huge incentive to optimize our work with clients from the first moments of therapy.
Of course, for a lot of ACT therapists, that’s easier said than done.
Limited time in therapy can be a blessing in disguise
Without strategies for organizing its application, many practitioners can find ACT difficult to use when time is short.
That’s exactly why we created focused acceptance and commitment therapy (FACT), a system for applying ACT’s core principles with speed and efficacy so you can make the most of every minute with clients.
And while condensing treatment can actually help us achieve better results in less time, brief interventions aren’t about trying to fit more things into a smaller window, or haphazardly rushing toward any intervention.
There’s a reason why the “F” in FACT stands for “focused” and not “fast.”
FACT is about making sure everything you bring to the table is purposeful and targeted.
As it turns out, getting more focused in this way is central to effective therapy in general.
Let’s look at an example of what we mean:
Clients come to us because they feel overwhelmed. Often, they’re experiencing big or multiple life challenges and feel stuck after being unable to make headway on their own.
In our desire to help, we can unintentionally replicate this issue by tackling too many things at once or pushing for change that’s too huge.
However, having sessions that are limited in length or number helps rule out this approach. There simply isn’t time to entertain the thought of “doing it all.”
Instead, it requires getting very narrow in our focus and targeting small changes.
And, while it might seem contradictory, this is how quick transformation actually happens.
By zeroing in on one small change at a time, we can help clients avoid becoming overwhelmed and build much-needed momentum.
Someone who has a drinking problem, for example, has likely already tried to stop drinking. In fact, they might hold onto rigid ideas that progress can only take the form of ending the drinking entirely.
A lot of therapists might buy into this as well!
But there’s a reason the client hasn’t succeeded in doing that: that kind of change is too big to be manageable all at once.
Instead, we need to break that problem down into smaller pieces that they can reasonably tackle.
A strategy for doing more with less
Once clients see something — anything — changing in their life, they will gain confidence in their ability to break patterns that previously felt impossible to disrupt.
This is the classic “domino effect” that is at the heart of strategic change approaches.
Still, for this strategy to be effective, we need to know which problem to target.
This is another place FACT can help.
The FACT method gives you a template for organizing the initial visit, so you can gather crucial information about your client’s life context in as little as ten minutes.
It also provides a simplified model for quickly conceptualizing psychological flexibility, so you can more easily understand the dimensions of a case and where an intervention will go furthest.
In this way, FACT can help you see that problems are more interconnected than we tend to think.
Depression, alcoholism, and social isolation might seem like three distinct problems, but they all have the same root cause: avoidance.
If we can identify and intervene in that person’s core avoidance agenda relating to depression, progress in that area will inevitably lead to improvements in the others.
This is the beauty of the FACT model.
It allows us to narrow our scope and do effective therapy in the moment that also sets up future wins, like lining up a row of dominoes.
Make a powerful change with a simplified approach
ACT is rich in metaphors, tools, and interventions. There are countless ways to attack any given problem.
While this allows for essentially boundless creativity, it can be difficult for many clinicians to use effectively in a short amount of time.
In fact, trying to sift through too many options and find a completely unique path forward with each client can cause clinicians to freeze up and waste precious time.
That’s why a central tenet of FACT is this:
When you simplify your approach, you set yourself (and your clients) up for success.
You don’t have to bring every possible tool or strategy into sessions with you — just the right ones.
Far from losing efficacy, having a tighter group of strategies gives you the opportunity to fine-tune them so they have more impact.
In addition, a simplified approach will help you build better rapport with clients. Instead of trying to create the flow of each session from scratch, you’ll have more mental space to be self-reflective and present.
As you can see, the trick to unlocking the power of brief interventions is bringing the right tools and a system you can use again and again to achieve incredible results with your clients.
And that’s why we are so excited to share that we are relaunching our Focused ACT for Brief Interventions (FACT) course.
This course is all about learning the FACT method so you can make a difference with any client, regardless of the presenting problem, even when time is seriously limited.
Inside the course, you’ll learn how to simplify your approach in a strategic way that will help you spark transformational change in as little as one session.
After years of teaching ACT and FACT to practitioners all over the world, we couldn’t be more excited to share FACT training with you in this online course format.
To learn more about Focused ACT for Brief Interventions, click here to check out a sneak peek into the course.