An Introduction to Acceptance and Commitment Therapy: Why It's GREAT for Kids :)

Hello readers :)

So today I am going to talk to you about my personal favorite theoretical orientation: Acceptance and Commitment Therapy, or ACT. 

The best way to introduce this style of therapy is to say that it takes the best of Cognitive Behavioral Therapy (CBT) and Existential-Humanistic Therapy and throws it in a blender. What we get is the beautiful result of ACT.

ACT believes that you do not have to get rid of the negative behaviors or feelings that you are experiencing. Instead, you focus your attention on how you can live with these feelings and adjust your lifestyle to make space for them. This is phenomenal for working with children because a lot of times, a child will be fused (ACT terminology) to the idea that they are a "bad child" or they are "never going to be good enough" for their parents, teachers, etc. ACT comes in and says, "Look. I know you feel this way, but let's change your perspective a bit and perhaps you will realize that your life situation is causing you to believe this and it's their version of the truth. What's yours?"

ACT also emphasizes living with the intention of meeting your values. The work that we do in Acceptance and Commitment Therapy drives a person to help understand what they value most in life, and a lot of the time, when they are dealing with things like depression or anxiety, they are not working in favor of their values. Kids a lot of times don't know what you mean when you say "Values-based lifestyle." So what we do when we work with kids is we sit them down with a deck of cards and we ask them to rank these things in order of what is most important to least important in their life. 

And then we take it a step further. We ask the child to work through each pile and take away things in increments of five (approximately, it can change based on the activity) until they are left with one thing. This is their most important value. This is what they are working towards in their life. As a therapist, it will really open the doors for you to understanding what their most important thing is in their life. It will guide your work with the client to help them work towards living in a way to meet their values.

The ACT therapist will conceptualize the client through the lens of the hexaflex. I provided a picture for you so that you can understand what I mean when I say hexaflex:

So the 6 parts of the hexaflex- The Present Moment, Values, Committed Action, Self-as-Context, Defusion, and Acceptance- work together to allow the client to gain Psychological Flexibility. I figure, we're all adults here, we can read a picture and see what each part of the hexaflex means. 

Is this treatment Evidenced Based? So far, yes! It's actually quite a new theory of work for therapists, and there have not been a huge amount of studies that show it's effectiveness. I can say from personal experience that this works quite well. This theory works well in conjunction with Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, Person-Centered Therapy...the list goes on and on.

How do you use this with children? Goodness, I could give you days of blog posts about the uses for this style of therapy with children. 

Some great goodies that I have used are in the bulleted list as follows:

• Values Card Sort- I described this for you earlier.
• Boat, Lake, Lighthouse- This activity starts out by you having your client draw a picture of a boat on a lake with a lighthouse in the distance. You then ask the client to draw a picture of storm clouds in the distance. As the client draws the storm clouds, you describe to them that they need to imagine that their family is stuck on this boat and a storm is coming. They want to get to the lighthouse. How does the family work together to get to that goal? This activity is great to use when working through a divorce or separation of a family- it helps the child understand that just because a family is separate does not mean that they still cannot work together to get to their goals. 
• The Magic Key- I love this exercise. I ask my client to imagine that they are in a huge castle and there are tons of doors around them, but they only have the key to one door. It's a magic key. I ask my client to describe to me what they would find behind the door and how that would change their life right now. I love using this activity when working with kids who are struggling to explain to me what they are hoping to achieve from therapy, or have experienced intense trauma and cannot start the conversation themselves.
• Walking Through a Swamp Metaphor- Again, I love this exercise. I ask my client to imagine that right now, they are on a flooded street and it magically became a huge swamp. There is something at the end of the swamp that my client wants to get to, but it's really difficult. I ask my client to imagine how they would gear themselves up to get through the swamp, how they would walk through it, and what they would do if they got stuck in the swamp. This is a great story to help your client understand the importance of their coping skills that you have taught them. :)
• Leaves on a Stream Mindfulness Meditation- I am just going to provide you with a link to the actual script. It's great for defusion with clients. Leaves on a Stream. 

This style of therapy uses a lot of mindfulness techniques to help the client get to a present awareness of their life. 

I hope this helped you understand this style of therapy, and will have a better understanding of why my activities are strongly focused on using mindfulness and present moment work with your clients (or children!) 

Thank you for reading, and keep planting the seeds of change in your little sprouts :)