Author: Janina Scarlet, PhD

Losing a parent can be devastating. Losing a parent and a sibling in one week can be excruciating. That is exactly what happened to “Joe” (not real name), after his father and brother both died a few days apart, following a car crash.

Experiential avoidance is an attempt to mitigate or evade contact with unwanted psychological events. Experiential avoidance becomes clinically relevant if it promotes acting in an unhealthy manner or prevents moving in valued directions and toward meaningful outcomes.

Notice that we used the tenuous word “attempt” in defining experiential avoidance. It’s important to understand that actions aimed at reducing contact with private events—such as emotions, sensations, and feelings—don’t ensure that these events will go away or won’t arise again. In fact, avoidance moves might eventually exacerbate the problematic repertoire.


The discoverer helps us push out to the edges and learn through trial and error.

Harnessing the power of the discoverer is one of the coolest aspects of DNA-v, the youth model of acceptance and commitment therapy (ACT). Step inside the discoverer with me for a moment, and imagine it for yourself.

You are a baby discoverer. One day at meal time you push that sippy cup right to the edge of the highchair tray, watch it fall to the floor, and listen to the pleasing clatter. Your parent laughs, picks it up, and places it back on the tray.

Exposure therapy is a behavioral treatment that involves gradually approaching a feared situation in a controlled and systematic manner. Exposure therapy is used to treat anxiety disorders, obsessive-compulsive and related-disorders, posttraumatic stress disorder, as well as other anxiety-related problems (Abramowitz, Deacon, & Whiteside, 2011; Nathan & Gorman, 2015).

Contextual behavioral science (CBS) is based in an evolutionary perspective of behavior. Behavior varies and is selected for continuation or repetition according to its functionality in serving the organism’s goals. Variation in behavior occurs through learning.

Humans are unique in their capacity to make use of arbitrary symbols as cues to transform how they respond to events. However, in order to talk about that, we have to  briefly mention the more ancient processes of respondent and operant learning.


Emerging from the CBS (cognitive behavioral science) and ACT (acceptance and commitment therapy) literature as a set of evidence-based psychotherapy processes, psychological flexibility involves the development of expanding and adaptive behavioral repertoires that can be maintained in the presence of distressing events that typically narrow behavioral repertoires.

Before you begin using ACT (acceptance and commitment therapy) with your clients, it’s best to have a good sense of the entire ACT (acceptance and commitment therapy) 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.

Have you ever wanted to be a Superhero? To have magical powers like Harry Potter or to have superpowers like Superman or Wonder Woman?

My name is Janina Scarlet. I was born and raised in Ukraine. When I was just a few months shy of my third birthday, there was a massive nuclear explosion a few cities away from us at the Chernobyl Nuclear Power Plant. This event forever changed my life.

My immune system was severely weakened due to radiation exposure. I would get sick very easily.  I got frequent nosebleeds, which wouldn’t clot. I spent many years in and out of the hospital.. A side effect which still affects me to this day is that whenever the weather changes, I experience severe migraines, and sometimes seizures.

Clinicians experienced in treating obsessive-compulsive disorder (OCD) are likely to be familiar with the use of cognitive behavioral therapy (CBT) as the primary treatment approach.  This highly effective treatment typically consists of three basic protocols:

  • psychoeducation about the disorder

  • cognitive interventions that challenge distorted ways of thinking about experiences

  • behavioral interventions, namely, exposure and response prevention (ERP), which involves confronting obsessive fears intentionally and resisting related compulsive physical and mental acts.


These are all buzzwords that have become more and more present in our national discourse in recent years. Within the mental health field, however, these discussions have been written about and researched for decades. In fact, there have been multiple taskforces, divisions, and guidelines developed to integrate multicultural competence in the provision of mental health services and research. Yet, there appears to be lingering challenges in translating the call for multicultural competence from literature to practice. Illuminating the greatest challenges to being or becoming a culturally competent therapist allows for strategic planning to ameliorate such barriers in ethical and effective care.


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