By Darrah Westrup, PhD, author of Advanced Acceptance & Commitment Therapy: The Experienced Practitioner’s Guide to Optimizing Delivery
One of the things to consider when deciding whether or not to introduce a particular idea, exercise, or metaphor in session, is whether doing so will optimize its message.
It’s about adding an additional level of gardening sophistication. The soil might be adequate for a seed to grow, but is this the optimal time for planting that particular seed? If you were to wait for another session or so, might that seed fare even better?
I have found the chessboard metaphor to be one of the most clinically powerful in ACT. Along with “passengers on a bus,” the chessboard metaphor typically resonates particularly for those clients who are struggling with a very negative conceptualized self or the perception of having no self. (As one such client stated, “If I let go of my anger, there’s nothing there; there’s no There, there.”)
While there are many opportunities throughout ACT where the chessboard metaphor and passengers on a bus might reasonably be applied, I like to hold these two back a bit until I feel the client has really been primed for them.
I have listened to many sessions during which the therapist brings the chessboard metaphor in early on, and it just doesn’t really land. The metaphor is received more as an intellectual idea, rather than resonating at a personal level. Or the client might take it very literally (that there’s no winning, for example) and completely miss the main message (the self that is larger than the pieces).
This misunderstanding is often due to the client’s inability to defuse from the content of her mind, to contact herself as the Thinker having thoughts. In these cases, the metaphor functions as just another idea, rather than representing the distinction between self and thoughts (and feelings, and so forth).
If the client can see that the control agenda is futile and costly, if he or she is at least considering willingness as an alternative and understands the distinction between looking at thoughts and from thoughts and has built some skill there, then they’re in a great place for an explicit discussion about the self being larger than the internal phenomena of the moment.
Similarly, the “passengers on a bus” metaphor works very well in many places, as it so nicely embodies all the core processes. That is exactly why I like to save it, and use it toward the end of therapy as a powerful way to tie the processes together and bring committed action home.
That said, there are many times I introduce it earlier because I think it will be the most effective strategy for a particular client at a particular point in time.
My suggestion for ACT therapists who want to enhance their timing in session is to pursue a questioning process along the following lines:
- Does the idea, exercise, or metaphor pertain to what’s actually happening in this session (in other words, getting present and considering the core processes currently in play)?
- How will introducing it serve to further the therapy? (What is its intended function?)
- Is there a reason to hold off? (This question could also be phrased as follows: Is there a more optimal time for it, given the current context and where the client is in terms of psychological ability?)
When engaging in detailed analysis of timing with supervisees and consultees, I have often seen that the therapist introduced a concept, metaphor, or exercise simply because the client said something that made the thought or exercise come to mind.
Sometimes that’s going to be spot on, sometimes not. Many providers have described times when they had some niggling sense that this may not be the best time to tackle or introduce something, but they “just couldn’t resist trying.”
At times like these, it’s important to give yourself permission to simply stop and attend to what’s happening. Is it really time to go for broke, or is it time to sit with the impulse?
Allowing yourself the opportunity to think about timing specifically will raise the odds of having good timing in your sessions.
There will likely be many opportunities to work with a particular process, as these behaviors are persistent and can manifest any number of ways. Keeping that in mind, can help you resist the urge to jump on something too soon?
A related misstep I have seen is when the therapist is following a particular agenda, and presents a metaphor or exercise based upon his session plan rather than considering what is actually happening in the room.
What often happens in this case is the exercise or metaphor falls flat or increases confusion because it simply doesn’t fit. More importantly, the therapist is conducting the therapy at the content level rather than process level—the cost being effective work with what is actually happening during the session.