Before you begin using ACT (acceptance and commitment therapy) with your clients, it’s best to have a good sense of the entire ACT model. This includes knowing a variety of core metaphors and exercises you can use, and having a working understanding of the basic theory.
The flexibility processes—acceptance, defusion, committed action, self-as-context, values, present moment awareness—are sometime presented as if they were separate. However, they are actually interdependent. Thus it’s important to allow time for a period of growth with the theory and therapy. Lacking a basic understanding of one process could lead to difficulties in implementing other processes, as well as confusion and dead ends in therapy.
In addition, without an overall understanding of the approach, therapists can easily introduce inconsistencies that might undermine the overall thrust of the intervention. So give yourself time to learn this complex and comprehensive model.
Giving ACT a try can allow you to see whether something new can happen and free up the therapy process.
A fairly common approach is to first use ACT with a client with whom you find yourself struggling. If this client is difficult, which is often the case, this may seem like a counterintuitive place to begin; however, because your old repertoire has already been failing in an important way, if you continue with the same approaches you’ve been using, you’ll probably continue to find yourself in the same place as the client: stuck.
Once you feel you have a healthy grasp of ACT you’ll be ready to apply it in session with your clients. Here, we will focus on two basic ways of beginning to incorporate ACT into your practice.
1. Standardized Manuals
One way to start implementing ACT is based on one of the standardized manuals available. Many are listed under “Therapist Guides” in the e-book Learning ACT Resource Guide.
Ideally, you would follow the manual from beginning to end with a client who presents with problems matching the specific treatment discussed in that manual. This has the advantage of pushing you into corners of the work where you may still feel awkward.
After you’ve followed a detailed ACT protocol with a few clients, we suggest that you put the protocol aside and move to tracking and targeting flexibility processes based on clients’ needs and your case conceptualizations.
2. ACT Workshops
Attending an experiential ACT workshop is truly one of the best ways to learn the ACT approach. ACT is centered on living fully with all experience—both negative and positive—and on the freedom and richness that purposeful living can bring.
Attending a workshop can help create these dynamics in your life, both in your personal way of being in the world and in your work with clients. It can also provide intuitive guidance about the function of flexibility processes, not just the form of these processes.
It’s important to be compassionate with yourself as you practice, and to give yourself time to reread sections on relevant concepts and approaches as you try to apply them. Also, be forewarned that you may experience some disruptions in your practice when you begin to use these approaches, particularly if you’ve been operating from control-based theories of intervention—CBT, DBT, family systems, psychodynamic therapy, existential-humanistic therapy. It is not at all uncommon for practitioners who are drawn to this work to initially feel awkward, confused, and anxious as they begin to apply ACT. With time and practice you’ll be able to move fluidly between any of ACT’s six core processes.