Synopses & Reviews
Acceptance and commitment therapy, or ACT (pronounced as a word rather than letters), is an emerging psychotherapeutic technique first developed into a complete system in the book Acceptance and Commitment Therapy by Steven Hayes, Kirk Strosahl, and Kelly Wilson.
ACT marks what some call a third wave in behavior therapy. To understand what this means, it helps to know that the first wave refers to traditional behavior therapy, which works to replace harmful behaviors with constructive ones through a learning principle called conditioning. Cognitive therapy, the second wave of behavior therapy, seeks to change problem behaviors by changing the thoughts that cause and perpetuate them.
In the third wave, behavior therapists have begun to explore traditionally nonclinical treatment techniques like acceptance, mindfulness, cognitive defusion, dialectics, values, spirituality, and relationship development. These therapies reexamine the causes and diagnoses of psychological problems, the treatment goals of psychotherapy, and even the definition of mental illness itself.
ACT earns its place in the third wave by reevaluating the traditional assumptions and goals of psychotherapy. The theoretical literature on which ACT is based questions our basic understanding of mental illness. It argues that the static condition of even mentally healthy individuals is one of suffering and struggle, so our grounds for calling one behavior 'normal' and another 'disordered' are murky at best. Instead of focusing on diagnosis and symptom etiology as a foundation for treatment-a traditional approach that implies, at least on some level, that there is something 'wrong' with the client-ACT therapists begin treatment by encouraging the client to accept without judgment the circumstances of his or her life as they are. Then therapists guide clients through a process of identifying a set of core values. The focus of therapy thereafter is making short and long term commitments to act in ways that affirm and further this set of values. Generally, the issue of diagnosing and treating a specific mental illness is set aside; in therapy, healing comes as a result of living a value-driven life rather than controlling or eradicating a particular set of symptoms.
Emerging therapies like ACT are absolutely the most current clinical techniques available to therapists. They are quickly becoming the focus of major clinical conferences, publications, and research. More importantly, these therapies represent an exciting advance in the treatment of mental illness and, therefore, a real opportunity to alleviate suffering and improve people's lives.
Not surprisingly, many therapists are eager to include ACT in their practices. ACT is well supported by theoretical publications and clinical research; what it has lacked, until the publication of this book, is a practical guide showing therapists exactly how to put these powerful new techniques to work for their own clients.
Acceptance and Commitment Therapy for Anxiety Disorders adapts the principles of ACT into practical, step-by-step clinical methods that therapists can easily integrate into their practices. The book focuses on the broad class of anxiety disorders, the most common group of mental illnesses, which includes general anxiety, panic disorder, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder.
Written with therapists in mind, this book is easy to navigate, allowing busy professionals to find the information they need when they need it. It includes detailed examples of individual therapy sessions as well as many worksheets and exercises, the very important 'homework' clients do at home to reinforce work they do in the office.
In her social fitness model of extreme shyness and social phobia, Lynne Henderson provides a thoughtful and measured road map to guide therapists through the twists and turns of treating a problem that is often underdiagnosed and undertreated. Of particular importance, Helping Your Shy and Socially Anxious Client
describes the role of high self-criticism in the cycle of social anxiety and avoidance, a cycle that traps socially anxious clients in a toxic emotional mix of fear, shame, and anger. Henderson then describes strategies to help free clients from this emotional quicksand so that that they can live fuller and more meaningful lives.”
Michael A. Tompkins, PhD, author of Anxiety and Avoidance
Readers of this volume are fortunate to get the benefit of Lynne Hendersons deep understanding of social anxietyunderstanding based both on her attention to the latest science and on her many years of clinical experience treating individuals who struggle with this problem. An outstanding contribution.”
Jacqueline B. Persons, PhD, director at the San Francisco Bay Area Center for Cognitive Therapy and clinical professor in the department of psychology at the University of California, Berkeley
Shyness and social anxiety can cause real misery and loneliness in peoples lives. In this important book, Lynne Hendersonone of the world leaders in the treatment of shynessoutlines her social fitness model and offers a wealth of insight into the problems and experiences faced by shy people. Based on considerable experience, as well as carefully researched and traditional cognitive behavior therapy interventions, this sympathetically written and easy-to-understand book will be of enormous help to many therapists for its clear and structured guidance.”
Paul Gilbert, PhD, author of The Compassionate Mind and Mindful Compassion
Humans are social animals. For this reason, shyness and social anxiety can be highly distressing and disabling. Fortunately, there are effective psychological strategies to overcome these problems. In her new book, Helping Your Shy and Socially Anxious Client
, Lynne Henderson describes a simple, step-by-step treatment approach that is based on decades of research. It is a must-read for every mental health care professional who wants a clear and comprehensive guide to successfully treating these common problems.”
Stefan G. Hofmann, PhD, author of An Introduction to Modern CBT and professor of psychology at Boston University
“In a nuanced and creative inversion of traditional approaches to the treatment of anxiety, Eifert and Forsyth offer clients the possibility of relinquishing their struggles with anxiety, by “treating” the struggle as the problem and letting fear play out to an increasingly disinterested audience of one. Acceptance, commitment, and mindfulness are essential to this process, and this book clearly lays the type of experiential learning foundation that allows clients to embody these concepts and, through their actions, develop a new relationship with their fears. This book will certainly become a vital clinical resource for any therapist, student or educator in the field of anxiety disorders.”
—Zindel V. Segal, Ph.D., the Morgan Firestone Chair in Psychotherapy and professor of psychiatry and psychology at the University of Toronto and author of Mindfulness-Based Cognitive Therapy for Depression
“Eifert and Forsyth present the complexities and nuances of acceptance and commitment therapy for anxiety disorders in a fascinating and conceptually illuminating style and in a manner that is amply detailed to guide clinical practice. The principles that underlie acceptance and commitment therapy—to relinquish attempts to control internal states and instead focus upon valued life directions and goals—are brought to life with excellent case examples throughout their step-by-step guide for treating anxiety disorders. This book will be an invaluable resource for theoreticians and clinicians, novice and experienced alike.”
—Michelle G. Craske, Ph.D., director of the Anxiety Disorders Behavioral Research Program at the University of California, Los Angeles and author of Origins of Phobias and Anxiety Disorders
“Eifert and Forsyth have done something revolutionary! They have taken the treatment of anxiety disorders far beyond the disease model that CBT has been stuck in by brilliantly examining the core psychological processes that make fear and anxiety disordered and explaining in clear language what all anxiety disorders have in common. Their conceptualization of fear and anxiety demonstrates the cutting edge of clinical research and development within CBT and its development into the so-called third wave behavior therapies. The book contains innovative and user-friendly session-by-session guidelines on how to apply ACT for all the major anxiety disorders. This therapist guide should be on every clinical psychology program’s reading list. It is truly an eye opener and a huge step forward in how we view and treat the suffering associated with anxiety disorders.”
—JoAnne Dahl, Ph.D., professor of clinical psychology at the University of Uppsala, Sweden, and author of Living Beyond Pain and Pain: A Vital Friend
“Behavior therapy is undergoing extraordinary change. Mindfulness, acceptance, and values-oriented interventions are increasingly being included in interventions for a wide variety of problems in living. Eifert and Forsyth’s new anxiety text is a stunning example of the potential for this new wave of behavior therapies to remain connected to their scientific roots while exploring emerging treatment issues and technologies. This book is a must for the bookshelves of both clinicians and treatment developers.”
—Kelly G. Wilson, Ph.D., assistant professor of psychology at the University of Mississippi and coauthor of Acceptance and Commitment Therapy
“This book provides concrete treatment guidelines that are firmly grounded in a new and intriguing approach to emotion regulation: Acceptance and Commitment Therapy. The authors are well known for their rigorous scientific studies and theoretical contributions to the field of anxiety disorders and behavior analysis. This book further demonstrates that they are highly skilled clinicians and masterful educators who are able to translate complex theories into simple and clearly formulated treatment techniques. The book is a reflection of the current paradigm shift from the studies of behaviors and cognitions to the study of and emotion regulation and, therefore, is a must-read for both the present and next generation of anxiety researchers.”
—Stefan G. Hofmann, Ph.D., associate professor of psychology at the Center for Stress and Anxiety-Related Disorders at Boston University, and Editor of Cognitive and Behavioral Practice.
“Acceptance and Commitment Therapy for Anxiety Disorders provides a detailed, step-by-step account of how therapists can use ACT to help people who are suffering from these problems. Its comprehensiveness and session-by-session guides will help people who are novices to this approach understand and apply the fundamentals of ACT. Experienced ACT practitioners will also find this an extremely valuable resource, as Eifert and Forsyth have deftly tailored core ACT techniques to target the primary issues of people with anxiety-related problems. In addition, this book provides a considerable amount of new and innovative, out-of-session exercises and materials clients can use to strengthen their commitment to move through their anxiety and lead a vital life that they will value. In all, it’s a one-stop-shop ACT guide for treating anxiety disorders.”
—Frank Bond, BA, P.G.Dip., M.Sc., Ph.D., C.Psychol., ICTLHE, senior lecturer in the Department of Psychology at Goldsmiths College, University of London
“This is an extremely useful book for professionals as well as educated clients. Focusing on the broad area of anxiety disorders, it does a superb job demonstrating how acceptance and commitment therapy can be applied to specific disorders. Avoiding the artificial constraints of DSM-IV or ICD-10 classifications of mental disorders, it emphasizes the functional similarities of the anxiety disorders and their common treatment strategies while at the same time taking into account some of their unique aspects.”
—Rainer F. Sonntag, MD, psychiatrist and psychotherapist in private practice in Olpe, Germany
“Eifert and Forsyth are interpreters rather than the creators of acceptance and commitment therapy (ACT). So when they explain its value for the treatment of anxiety, they ground their commitment to this approach in their own extensive clinical and research experience in anxiety disorders, not in uncritical acceptance. Because they really understand the psychology of anxiety, they have produced an authoritative, beautifully written, usable manual for clinicians. Calling it a manual, however, belies its theoretical sophistication and its ability to inspire rather than stipulate. These properties make it particularly useful in diverse cultural and global contexts, where it can easily be molded to the real lives of real clients.”
—Ian M. Evans, Ph.D., professor and head of the School of Psychology at Massey University in Palmerston North, New Zealand, fellow of the American Psychological Association and the Royal Society of New Zealand, and author of Nonaversive Behavioral Interventions
"This brilliant, original analysis of the nature of contemporary shyness is a must-read for everyone interested in the human condition-shy people and the rest of us, as well."
—Philip Zimbardo, founder of the Heroic Imagination Project and author of Shyness and The Lucifer Effect
"It is so refreshing to find a book of this kind that helps and supports without patronizing or pathologizing. Lynne Henderson combines ideas from psychological theory and clinical practice with the wisdom of Buddhist spirituality to cultivate a unique new approach to understanding shyness. Principles of compassion, empathy, and mindfulness are presented as the tools with which people can better manage their shyness and live positively with it in everyday life. By nurturing self-acceptance rather than self-blame and criticism, the book shows we can promote greater tolerance in both personal and cultural attitudes to shyness."
—Susie Scott, senior lecturer in sociology at the University of Sussex, UK, and author of Shyness and Society and Making Sense of Everyday Life
"A remarkable book that turns the problem of social anxiety inside out, emphasizing inner compassion as the antidote for the self-criticism common among those who are extremely shy. The Compassionate Mind Guide to Improving Social Confidence and Reducing Shyness is a sincere, straightforward, and novel approach to shyness written by a compassionate and astute clinician. The book has broken new ground on the topic and is certain to help many achieve greater social confidence and success."
—Michael A. Tompkins, PhD, founding partner of the San Francisco Bay Area Center for Cognitive Therapy and assistant clinical professor at the University of California, Berkeley
"This book addresses the very essence of what is missing in much of the contemporary mental health treatment industry-compassion. Most books focus on theories and procedures, but it is the healing power of compassion that is the engine that makes these things work. Too often, this engine is dismissed as non-essential or not sufficiently novel to warrant discussion. This volume specifically and intentionally attempts to correct this omission. But the task is tremendous-how do you describe compassion, let alone teach one to have it? This is a valuable effort to do these very things, and mental health treatment will benefit by this book's success."
—Larry E. Beutler, PhD, William McInnes Distinguished Professor of Clinical Psychology at Palo Alto University
"Written by a highly experienced therapist, this book is an essential read for anybody who wants to learn more about shyness and strategies to deal with it by using compassion-focused therapy. Lynne Henderson integrates cognitive-behavioral principles with compassion-focused therapy, a more recent intervention developed by Paul Gilbert. The resulting book is a fascinating text that will be of great value to people who want to learn more about compassion and shyness."
—Stefan G. Hofmann, PhD, professor of psychology at Boston University and author of Cognitive-Behavioral Therapy for Social Anxiety Disorder
This book is a masterful contribution to the literature on the psychological treatment of depression. In exquisite detail, and full of wonderful metaphors and moment-by-moment description of the process of therapy, it will become required reading for all therapists who seek to help people find a way through their struggles with depression.
—Prof. Mark Williams, professor of clinical psychology and Wellcome Principal Research Fellow at the University of Oxford, holding a joint appointment in the Departments of Psychiatry and Experimental Psychology
This professional book is the first to outline the conceptual roots, empirical basis, and practical application of acceptance and commitment therapy (ACT) for unipolar depression. In a clear and accessible style, the author guides mental health professionals and students alike in the strategic application of ACT as a supplement or alternative approach to available treatments for depression. Readers learn how to integrate and use acceptance and mindfulness strategies with commitment and behavior change strategies to help depressed clients live better, not simply to feel better. The book includes several well-crafted examples, clinical dialogues, and practical exercises, and a step-by-step integration of the material into a twelve-session protocol. It is a vital clinical resource for professionals who are committed to helping restore the lives of those who are stuck and wallowing in depression and misery.
—John P. Forsyth, Ph.D., associate professor of psychology and faculty director of the Anxiety Disorders Research Program at the University at Albany, SUNY, and author of Acceptance and Commitment Therapy for Anxiety Disorders and ACT on Life Not on Anger
This book provides more than an excellent explication of applying ACT to depression. Zettle’s presentation of the fundamental ACT principles and processes is so clear and comprehensive that readers will almost certainly see the potential application of them to many other forms of human suffering in addition to depression. I give this book my highest recommendation.
—Hank Robb, Ph.D., ABPP, past president of the American Board of Counseling Psychology and founding board member of SMART Recovery™
I enthusiastically endorse Zettle’s ACT for Depression. Well-written and comprehensive, this text is a valuable addition to the ACT literature. Addressing one of the most widespread difficulties encountered in clinical practice, this resource details a robust treatment which will be well-received by practicing clinicians with both behavioral and non-behavioral backgrounds alike.
—R. Trent Codd, III, Ed.S., LPC, LCAS, president of the Cognitive-Behavioral Therapy Center of WNC, P.A., in Asheville, NC
Having been present at the birth of ACT approximately thirty years ago, Zettle articulates ACT’s basic principles with the ease and clarity that can only come from a seasoned veteran. The rationale and techniques for applying ACT to depression are sensitive, satisfying, and establish Zettle as a true expert on depression as well as a master clinician. The book succeeds at offering both a clear, concise articulation of ACT for depression in terms of core, functional processes, allowing clinicians to apply ACT flexibly and functionally as well as a session-by-session manual for clinicians to follow when the needs for structure and support are a priority. It is easy to read with out sacrificing the philosophical and theoretical complexity of the approach. I recommend it for novice and experienced ACT clinicians as well as other clinicians and clinical students wishing to add acceptance and commitment techniques to their clinical repertoires.
—Jonathan W. Kanter, Ph.D., assistant professor of psychology, director of the Depression Treatment Specialty Clinic, and coordinator of the University Psychology Clinic at the University of Wisconsin-Milwaukee
Depression is the number one mental health problem seen in clinical practice and any clinician interested in practicing acceptance and commitment therapy is going to want to have this book within easy reach. Zettle provides a well thought out, easy to understand approach to treating the depressed client using the ACT framework. Capitalizing on his many years of clinical experience using the ACT model, Zettle offers numerous practical insights into managing the ongoing process of therapy, and uses brief case examples to highlight key points. The session by session ACT protocol described in the second half of the book will be a fantastically useful aid to clinicians in the field.
—Kirk Strosahl Ph.D., coauthor of Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change and A Practical Guide to Acceptance and Commitment Therapy
Helping Your Shy And Socially Anxious Client
presents a breakthrough therapeutic approach to treating social anxiety.
In a world dominated by extroverts, being shy or socially anxious can make life especially challenging. And while there is nothing wrong with being naturally introverted, avoiding social contact due to extreme fear and anxiety can be very damaging both mentally and physically.
As a therapist, you understand that avoidance can often make a clients anxiety worse. But many clients with shyness and social anxiety believe they can never change. In fact, they may strategically adjust their lives to avoid social activities or situations that make them uncomfortable. In a sense, they allow their social "muscles" to atrophy, and in the end may become even more alienated and despondent. There is hope.
Just as physical fitness strengthens the body, "social fitness" can be developed through habit and action. In Helping Your Shy and Socially Anxious Client, shyness expert Lynne Henderson presents the Social Fitness programa twelve session cognitive behavioral model for clients with shyness and social anxiety. Inside, mental health professionals will learn powerful tools for helping clients strengthen their social skills, track their successes, and learn to cope with setbacks or hurdles.
The techniques described in this manual were developed for the Stanford Shyness Clinic by Philip Zimbardo, and are currently being used by the Shyness Institute in Berkeley to educate therapists and other counselors. Find out more at shyness.com.
This is the first step-by-step professional book that teaches therapists how to apply and integrate acceptance and mindfulness-based treatment for anxiety disorders in their practice by presenting acceptance and commitment therapy concepts, principles, and techniques.
If recent professional publications and conferences are any indication, acceptance- and mindfulness-based therapies are the future of clinical psychology. A CBT-Practitioner's Guide to ACT helps professionals whose clinical educations focused on traditional, change-based cognitive behavior therapies navigate the practical and theoretical challenges that come with the switch to the more promising, acceptance-based strategies.
Interest in acceptance and commitment therapy (ACT) is expanding rapidly. Many of those who are interested in ACT are trained using a mechanistic cognitive behavioral therapy model (or MCBT). Utilizing both ACT and MCBT together can be difficult, because the approaches make different philosophical assumptions and have different theoretical models. The core purpose of the book is to help provide a bridge between ACT and MCBT.
The emphasis of this book will be applied psychology, but it will also have important theoretical implications. The book will highlight where ACT and MCBT differ in their predictions, and will suggest directions for future research. It will be grounded in current research and will make clear to the reader what is known and what has yet to be tested.
The core theme of A CBT-Practitioner's Guide to ACT is that ACT and CBT can be unified if they share the same philosophical underpinnings (functional contextualism) and theoretical orientation (relational frame theory, or RFT). Thus, from a CBT practitioner's perspective, the mechanistic philosophical core of MCBT can be dropped, and the mechanistic information processing theory of CBT can be held lightly and ignored in contexts where it is not useful. From an ACT practitioner's perspective, the decades of CBT research on cognitive schema and dysfunctional beliefs provides useful information about how clients might be cognitively fused and how this fusion might be undermined. The core premise of the book is that CBT and ACT can be beneficially integrated, provided both are approached from a similar philosophical and theoretical framework.
The authors acknowledge that practitioners often have little interest in extended discussions of philosophy and theory. Thus, their discussion of functional contextualism and RFT is grounded clearly in clinical practice. They talk about what functional contextualism means for the practitioner in the room, with a particular client. They describe how RFT can help the practitioner to understand the barriers to effective client action.
Based in compassion-focused therapy (CFT), a therapeutic model that combines attachment theory, neuroscience, and mindfulness, The Compassionate-Mind Guide to Building Social Confidence helps readers gain the confidence they need to connect with others and develop skills for reducing shame and self-judgment. Written by Lynne Henderson, who is founder and codirector, with Phillip Zimbardo, of The Shyness Institute, this book offers readers skills and exercises for overcoming problematic shyness and feeling more comfortable around others.
Shyness is a universal human emotion, a blend of fear and interest, and is associated with many positive personality traits: a considerate nature, thoughtfulness, and the ability to be a good listener, to name a few. However, withdrawing from others has its drawbacks, and if you're very shy, it's likely that you've experienced some of them: loneliness, depression, and self-blaming thoughts that are much harsher than other people's criticism would ever be. The Compassionate-Mind Guide to Building Social Confidence offers a supportive program based in compassion-focused therapy for moving past social anxiety and the self-critical thoughts that propel it.
The program in this book helps you both accept your shyness as part of your personality and challenge your social anxiety when it keeps you from living the life you want. This book also provides dozens of exercises that will help you practice mindfulness, imagery, compassionate thinking, and compassionate action-critical skills that will help you develop the ability to overcome shyness and make strides toward complete social confidence.
This social fitness training program will help you:
- Quiet the thoughts that trigger social anxiety
- Replace anxious thoughts with compassionate ones
- Identify and achieve your goals for social confidence
- Practice assertiveness skills
ACT for Depression adapts the research-proven techniques of acceptance and commitment therapy (ACT) into a powerful set of conceptualization, assessment, and treatment techniques clinicians can use to help clients with depression, the second-most common mental health condition.
Psychological research suggests that cognitive behavior therapy (CBT), used alone or in combination with medical therapy, is the most effective treatment for depression. Recent finding, though, suggest that CBT for depression may work through different processes than we had previously suspected. The stated goal of therapeutic work in CBT is the challenging and restructuring of irrational thoughts that can lead to feelings of depression. But the results of recent studies suggest that two other side effects of CBT may actually have a greater impact that thought restructuring on client progress: Distancing and decentering work that helps clients stop identifying with depression and behavior activation, a technique that helps him or her to reengage with naturally pleasurable and rewarding activities. These two components of conventional CBT are central in the treatment approach of the new acceptance and commitment therapy (ACT). This book develops the techniques of ACT into a session-by-session approach that therapists can use to treat clients suffering from depression.
The research-proven program outlined in ACT for Depression introduces therapists to the ACT model on theoretical and case-conceptual levels. Then it delves into the specifics of structuring interventions for clients with depression using the ACT method of acceptance and values-based behavior change. Written by one of the pioneering researchers into the effectiveness of ACT for the treatment of depression, this book is a much-needed professional resource for the tens of thousand of therapists who are becoming ever more interested in ACT.
About the Author
Georg H. Eifert, PhD, was ranked among the top thirty researchers in behavior analysis and therapy in the 1990s, and has authored over 100 publications on psychological causes and treatments of anxiety and other emotional disorders. He is clinical fellow of the Behavior Therapy and Research Society, a member of numerous national and international psychological associations, and serves on several editorial boards of leading clinical psychology journals. He is also a licensed clinical psychologist. He is coauthor of Acceptance and Commitment Therapy for Anxiety Disorders and ACT on Life, Not on Anger.John P. Forsyth, PhD, is a scientist, writer, and licensed clinical psychologist in upstate New York. He has traveled the world giving talks and workshops to the public and professionals about the benefits of mindful acceptance, kindness and compassion, and how to live a valued life using a new approach to psychological health and wellness called acceptance and commitment therapy (ACT). He is associate professor of psychology, director of the doctoral training program in clinical psychology, and director of the Anxiety Disorders Research Program at the University at Albany, State University of New York. He has published many articles about how excessive struggle with unpleasant thoughts and emotions feeds human suffering, and what mindfulness and acceptance can offer as a solution. He is coauthor of Acceptance and Commitment Therapy for Anxiety Disorders, ACT on Life, Not on Anger, and The Mindfulness and Acceptance Workbook for Anxiety. His work has helped foster growing international interest in acceptance and mindfulness approaches in psychology, mental health care, medicine, and society.Steven C. Hayes, PhD, is Nevada Foundation Professor and director of clinical training at the department of psychology at the University of Nevada. An author of 38 books and over 540 scientific articles, his career has focused on analysis of the nature of human language and cognition, and its application to the understanding and alleviation of human suffering and promotion of human prosperity. Among other associations, Hayes has been president of the Association for Behavioral and Cognitive Therapy, and the Association for Contextual Behavioral Science. His work has received several awards, including the Impact of Science on Application Award from the Society for the Advancement of Behavior Analysis, and the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy.