psyc 164

Acceptance and Commitment Therapy Assignment

***Make sure you read and understand the ACT reading prior to doing this assignment. 

Instructions:

1. Reflect on your current life. Describe how close you are to your values/goals in the following
areas:

A. Personal health and development

B. Relationships with others (might include family, friends, partners)

C. Leisure Activities (hobbies, things you do for fun)

D. Work/Career/School

2. Choose one set of values as the point of focus for this exercise (could be general or one very
specific goal)

3. Draw your own choice point diagram. On the left, list things that you are thinking, feeling or doing
that are taking you away from your value. On the right, list the value and behaviours you might be
currently engaged in that are taking you toward the goal.

4. In a previous module, I took you through a mindfulness tutorial. Try one, 5 minute session,
observing thoughts that come up when you think about your value stated in question 2. Are you able
to stay distant and just observe? Or did any thoughts draw you in? Were there any surprises for you?
How did you feel about the mindfulness experience? Describe your experience

5. If you evaluate the items on the right hand side of your choice point – are there any gaps in skill
development? List two things you could do this week that would bring you closer to your stated
value.

6. Do you think this is a technique that could help you unhook from your thoughts and commit to
behaviours that are more values based? Are there any obstacles you can identify keeping you from
trying this technique?

For this assignment:

Please try to answer each question fully. Question 1 should be at least a couple of paragraphs,
question 2 a small paragraph, a diagram showing a filled out choice point. The discussion for question
4 should be a couple of paragraphs, as well as for questions 5 or 6, resulting in an assignment that is 3
or 4 pages long (one page will be the choice point diagram), double spaced and typed (the diagram
can be hand-written and uploaded as a photo). As always, if you aren’t sure you are on the right

track, feel free to send it to me through email for a look before submission. And let me know if you
have any questions, okay? 

Cognitive behaviour therapy

Psychology 164, Fall 2020

1

         What is Cognition?
Our cognitions are our beliefs, thoughts, expectations, attitudes and perceptions.
Historically, behaviourists didn’t study cognitions because thoughts weren’t directly observable. However, modern behaviourists understand that through talk therapy, cognitions can be studied by what the person says they are thinking and the actions they perform while they are describing those cognitions.

        Types of CBT
There are many types of CBT, but we’ll focus on the two most common:
Cognitive Re-structuring Methods: These therapies focus on changing dysfunctional thoughts that arise, as they often trigger negative emotional states and dysfunctional behaviours
Acceptance and Commitment Therapy: These therapies focus on fostering self-compassion and acceptance that sometimes negative thoughts will emerge.

Cognitive Restructuring
The foundational belief is that irrational/dysfunctional thoughts are the source behind many behavioural difficulties
If these irrational thoughts are replaced by rational thoughts, many of the individual’s difficulties will disappear

Types of “irrational” thoughts
All-or-nothing thinking – You see things in black-or-white categories. If a situation falls short of perfect, you see it as a total failure. When a person on a diet ate a spoonful of ice cream, they told themselves, “I’ve blown my diet completely.” This thought upset them so much that it triggered binge behaviour.
 Overgeneralization – You see a single negative event, such as a romantic rejection or a career reversal, as a never-ending pattern of defeat by using words such as “always” or “never” when you think about it.   e.g.  Your partner forgets to reserve a restaurant for Valentine’s Day and your thought is, “They never do anything romantic.”  Can result in an inflated negative feeling toward partner.

Cont’d
Mental Filter – You pick out a single negative detail and dwell on it exclusively, so that your vision of reality becomes darkened, like the drop of ink that discolors a beaker of water. Example: You receive many positive comments about your presentation to a group of associates at work, but one of them says something mildly critical. You obsess about his reaction for days and ignore all the positive feedback.
Discounting the positive – You reject positive experiences by insisting that they “don’t count.” If you do a good job, you may tell yourself that it wasn’t good enough or that anyone could have done as well. Discounting the positives takes the joy out of life and makes you feel inadequate and unrewarded.

Cont’d
Jumping to conclusions – You interpret things negatively when there are no facts to support your conclusion.
Mind Reading : Without checking it out, you arbitrarily conclude that someone is reacting negatively to you.
Fortune-telling : You predict that things will turn out badly. Before a test you may tell yourself, “I’m really going to blow it. What if I flunk?” If you’re depressed you may tell yourself, “I’ll never get better.”

Cont’d
Magnification – You exaggerate the importance of your problems and shortcomings, or you minimize the importance of your desirable qualities. This is also called the “binocular trick.”
 Emotional Reasoning – You assume that your negative emotions necessarily reflect the way things really are: “I feel terrified about going on airplanes. It must be very dangerous to fly.” Or, “I feel guilty. I must be a rotten person.” Or, “I feel angry. This proves that I’m being treated unfairly.” Or, “I feel so inferior. This means I’m a second rate person.” Or, “I feel hopeless. I must really be hopeless”

Cont’d
“Should” statements – You tell yourself that things should be the way you hoped or expected them to be. After playing a difficult piece on the piano, a gifted pianist told herself, “I shouldn’t have made so many mistakes.” This made her feel so disgusted that she quit practicing for several days. “Musts,” “oughts” and “have tos” are similar offenders. “Should statements” that are directed against yourself lead to guilt and frustration. Should statements that are directed against other people or the world in general, lead to anger and frustration: “He shouldn’t be so stubborn and argumentative!” Many people try to motivate themselves with shoulds and shouldn’ts, as if they were delinquents who had to be punished before they could be expected to do anything. “I shouldn’t eat that doughnut.” This usually doesn’t work because all these shoulds and musts make you feel rebellious and you get the urge to do just the opposite.

Cont’d
Labeling – Labeling is an extreme form of all-or-nothing thinking. Instead of saying “I made a mistake,” you attach a negative label to yourself: “I’m a loser.” You might also label yourself “a fool” or “a failure” or “a jerk.” Labeling is quite irrational because you are not the same as what you do. Human beings exist, but “fools,” “losers” and “jerks” do not. These labels are just useless abstractions that lead to anger, anxiety, frustration and low self-esteem.

Cont’d
Personalization and Blame – Personalization comes when you hold yourself personally responsible for an event that isn’t under your control.  e.g. Your partner reacts badly to something you shared and you blame yourself for those feelings, rather than letting the other personal hold accountability for their own feelings.  Personalization leads to guilt, shame and feelings of inadequacy. 
Some people do the opposite. They blame other people or their circumstances for their problems, and they overlook ways they might be contributing to the problem: “The reason my marriage is so lousy is because my spouse is totally unreasonable.” Blame usually doesn’t work very well because other people will resent being scape-goated and they will just toss the blame right back in your lap. It’s like the game of hot potato–no one wants to get stuck with it.

How do restructuring methods work?
Ellis’ Rational-Emotive Behaviour Therapy:
1.  Belief that the foundation for difficult emotions and behaviour stems from irrational cognitions.
2.  Directly counters faulty logic in the client by asking for evidence and by countering with opposite data (for example, the statement “I have no friends” – the therapist would directly ask for evidence – so no one has ever talked to you, asked you over to hang-out, phoned you, wanted to spend time with you? Individual admits that people ask them to come over, phone, etc. and the therapist uses that as data to counter the faulty logic and replace it with something more functional such as “Hmm…I’m feeling lonely. I haven’t seen my friend in a while, I should call him/her.” ) If you think about your own life, what kinds of emotions and behaviours might be triggered by the first vs. the second statement?
Challenging the faulty logic is then followed by homework exercises that involve in vivo desensitization and awareness training so that the person becomes more aware of the role thoughts have in their lives.

        Beck’s Approach
Originally designed to treat depression, now used for many psychopathologies, this is also a restructuring method, although in Beck’s method, the therapist doesn’t play a directly confronting role, but rather a role of co-researcher – helping the individual test their own hypotheses through experience and journaling.
Three steps:
First, envisioning stress-invoking experience and emotions elicited by those experiences; and laddering to determine the core belief about oneself (bring awareness to the underlying belief behind the triggers.)
 Second, hypothesis testing through experiences and data collection
third, homework assignments requiring overt behaviours that are incompatible with cognitions. 
                              Wait…what? What does that mean?

  Use of Journals
The journal is used to collect data about your own thoughts, emotions and behaviour
First: write down a trigger event (the trigger event is some event in the environment that elicits some response in you). For example, let’s say you suffer from exam anxiety. The trigger event might be the announcement of an upcoming exam.
Second:  Write down the thought that was elicited by the trigger event. Using the case of exam anxiety, it might be “I’m going to crack under the pressure and fail the test!” or “My mind is going to go blank.”
Third:  Write down the emotion elicited by that thought. It is likely to be stress, anxiety, fear…
Fourth:  Write down behaviours that occur as a result of these beliefs.  Avoiding exams, leaving mid exam, avoiding studying, trying to study while highly anxious

Journaling cont’d
Continuing to journal this way for a few week’s, clients begin to understand their patterns of dysfunctional thoughts, which the therapist helps them challenge by engaging in small homework tasks that will have them taking practice tests in increasingly more demanding environments. Each time the person successfully passes the test, it further acts to contradict the original dysfunctional thought.
Each session, the journal is shared with the therapist and they discuss what happened, the patterns noticed and ways to contradict the core belief.
Excellent video example of a sample CBT session:

Acceptance and Commitment Therapy
This method allows the client to understand that everyone has negative thoughts now and then…it’s normal. However, it isn’t the negative thought that is dangerous, but rather how much the individual attaches to that thought and allows it to elicit negative emotions and dysfunctional behaviour.
People are taught to practice relaxation and to just watch the thoughts come and go without forming an emotional attachment. Negative thoughts are just noticed, labeled “thinking” and let go.
The commitment part of therapy is similar to that of behavioural homework in re-structuring techniques. Using the example from before, the person would label the thought “I’m going to fail” as a “thought” and let it go. They would then commit to studying as much as they could for the exam.
We’ll be covering the tools in much more detail in the document that follows.

Example for you to try…
Stephen is a shy senior at high-school, who has recently made the football team. As a result, he’s been invited to a lot of parties. However, he is extremely anxious about these parties and describes himself as getting completely tongue-tied and red, and feels like everyone in the room is looking at him, thinking he shouldn’t be there, what a geek, etc. He has noticed that over the past couple of weeks his anxiety about parties is getting worse. As soon as he gets there, the anxiety gets so bad that he finds some excuse to leave (he gets his friend to call him with a fake “emergency” so he can leave with an excuse) and he also has developed several fake “illnesses” to keep him from going to several of the parties. He’s so anxious that he’s even considering quitting the football team. Explain how you could use cognitive-behavioural therapy. How would you account for Stephen’s anxiety and what steps would you take to help him?
1.Give an example of a type of irrational thought exhibited by Stephen.
2.If you asked Stephen to write a journal entry showing the activating event, the cognition, the emotion and the behaviour, what would he likely write down?
3.How would you challenge his faulty cognitions? Give an example.
4.What kind of homework would you give Stephen to counter his current behaviour of escaping and avoiding parties?
If you could share your answers to these questions with the group that would be great.

MINDFULNESS

DO YOU EVER…

• Walk, bus, bike or drive somewhere and when you reach your destination, have no idea how
you got there?

• Take a long time to get to sleep because as soon as you lie down your mind starts to “chatter”
about the events of the day or what you hope to accomplish the next day?

• Sit down to eat, then look down to realize your plate is empty and you don’t remember eating?

• Try to anticipate how certain events are going to play out before they happen? Create imagined
conversations with partners, family, friends or co-workers;

worry about how your boss is going to react to your request

for a shift change; worry about how you’re going to

perform on a test, or find time to write the paper that is due?

• Spend time thinking about past conversations? What you may or may

not have said, what the other person said, reliving arguments or

emotionally charged events?

• Feel tense, stressed, exhausted or drained at the end of the day?

• Assume how another person feels, or imagine that another person is

angry or disappointed with you?

• Multi-task so that you don’t remember any single event that you accomplished?

WHY IS THIS PROBLEMATIC?

• Our body is experiencing the present, while our mind is

in the past or future – it forces a disconnect.

• Body reaction to stress: HPA axis

• Body’s design for homeostasis – effects of mindlessness

on that

• Is this a real or perceived threat? Brain can’t tell

difference.

• Effects of disconnect over time…

https://www.youtube.com/watch?v=aNCB1MZDgQA

https://www.youtube.com/watch?v=aNCB1MZDgQA

WHAT IS MINDFULNESS?

• MINDFULNESS is paying attention in a particular way: On purpose , in the present moment

and non-judgmentally. – Dr. Jon Kabat Zinn

• https://www.youtube.com/watch?v=1_h-Zn9pKAU

• Increases awareness and skillful handling of mental processes

that cause emotional distress or behavioural dysfunction

• The idea is to quieten your body and mind, pay attention to your

body and allow thoughts to come and go without attaching to them

• This allows you to become more aware of the sometimes harmful

chatter that is happening covertly and allows you to work

on minimizing its impact.

https://www.youtube.com/watch?v=1_h-Zn9pKAU

A FIVE MINUTE PRACTICE

• Diaphragmatic Breathing

• Body Scan : Paying Attention to each body part, adjusting so maximally

comfortable

• Guided 5 minute mindfulness session.

https://www.youtube.com/watch?v=y1dmKZg13Yw

https://www.youtube.com/watch?v=y1dmKZg13Yw

JOURNALING

Acceptance and Commitment Therapy

Cognitive Behaviour Therapy vs. Acceptance and Commitment Therapy

I think one of the best ways to sum up CBT vs. ACT is to talk about the radio analogy. As you go about
your day, your mind is constantly chattering away in the background, kind of like an annoying, often
negative, radio station. If you are frequently tuned into that radio station, it interferes with your ability
to focus on what you’re currently trying to do, which brings you into a state of disconnection with your
current life. It can also foster negative emotions and trigger behaviours that include escape and
avoidance. So what are your options? You could try to turn the radio off…but this particular radio
station, unfortunately, can’t be turned off completely. You could bring in another, bigger radio station
full of positive thoughts and messages and try to out-blast the negative radio station, but often that
means trying to go about your day with TWO loud radio stations blasting in competition in the
background. The third option is to allow the negative radio station to play quietly in the background,
without fighting it. You commit to your everyday, current life, but every once in a while, listen to one of
the songs if it is playing something that might be useful to you in your current life. The two-radio
analogy is similar to traditional CBT techniques, which try to replace negative thoughts with more
positive or constructive thoughts. The quiet background analogy is similar to ACT, where it is accepted
that the mind, due to evolution and conditioning, is automatically programmed to re-hash old stressors,
anticipate anxiety-provoking events, and generally worry about everything. Once it is accepted that
these kinds of thoughts are normal and experienced by everyone, the focus becomes two-fold – “un-
hooking” those thoughts so that they lose the ability to pull on your emotions and behaviours, and once
again become part of an inconsequential background, and putting energy and focus into behaviours that
bring you closer to your values and goals. ACT is a complex, multi-layered approach, and well outside
the confines of this course, but I wanted to introduce you to some of its tools so that you can get a sense
of how to use it in your life. First…a little video about our “survival” brain that we inherited from our
ancestors, that helps to explain why we are programmed to have this constant, negative radio station in
the background.  https://www.youtube.com/watch?v=kv6HkipQcfA

The Happiness Myth

In our modern day world, our society holds collective ideas about how we should behave, what we
should think and how we should live to be “happy.” It dictates what we “need” to be happy, successful
and what it is to lead “meaningful” lives. By now, I’m hoping you recognize that those terms mean
something different to each person, and what is considered “meaningful” changes depending on the
perspective. For some, the desire to have close, fulfilling relationships is “meaningful”, for others it
might be having a successful career with financial security, or for some it might mean reaching a physical
goal such as completing a marathon. The thing is, our goals don’t have to be big to be meaningful. So,
part of ACT is recognizing that the need to be happy all the time is a myth – it isn’t possible and isn’t
really much of a goal. Instead, the focus is on values, and how to live in a way that is closer to our own
personal values, without judgment and constant comparison to a society that is trying to tell everyone
how to live. There are no real “shoulds.” Figuring out what you want, what you value, what would be

“meaningful” to you is step number one. Then figuring out the behaviours that bring you closer to those
values, while allowing the “should” statements to play quietly in the background on the negative radio
station is step number two. This next video gives you a little message about the happiness myth. 

Defining your Values and Goals

Start by taking a look at your life. Let’s pretend we’re doing a before and after ACT documentary on
you. What would the camera crew record at present? What would you be doing? How would you be
feeling? What would they see? Now let’s imagine you’ve successfully taken steps to quieten and
unhook from your negative radio station thoughts and feelings, and you’ve reached your goals and are
living a life that is aligned with your values. What would that look like? What would you be doing
differently? What would you have stopped doing? What would you have started doing? How will you
be treating yourself differently? What people would be in your life? How will you be interacting with
the world? In doing this exercise, you start to get a sense of where you’re at in various parts of your life:
relationships, meaningful work/school, creative endeavors, etc. and where you want to end up. And
now that you have some of that defined, you can start the work to help you get there.

Introducing the

Choice Point

So the choice point is an ongoing check-point you can use to help you identify when you’re engaging in
thoughts and behaviours that are taking you further away from your values and a fulfilling, meaningful
life, or when you’re engaging in thoughts and behaviours that are moving you toward your goals and
values. To help you conceptualize this, you can use this diagram:

Behaviours, thoughts Values you want to live by and

and feelings moving you strengths and skills you can use

away from values and goals

Value Consistent: moving toward the life
outcome you want, acting effectively,
behaving like the person you want to be

Value Inconsistent: moving away from the
life outcome you want, acting ineffectively,
behaving unlike the person you want to be

Choice Point

So, let’s say we have a person who has been struggling with social anxiety for quite some time. The
current thoughts, feelings and behaviours of this person are consistently moving her away from values
she wants to live by and the life she wants to lead. First, we ask her to reflect on the documentary crew
before and after, asking her to concentrate on “after.” This is how she sees herself leading a full,
meaningful life:

I go out with friends on weekends to movies, concerts, and clubs

I go to the bookstore on my own at least once a week

I have a close relationship with my mom

I have a job related to books

I have a long-term partnership with someone

For this person, this currently defines a fulfilling, meaningful life. Now we ask her what she is currently
doing to move herself closer to those values.

I’m taking online courses toward an English literature degree

I’m on dating apps to try and meet someone

The items from these two lists would be placed on the right side. Now we ask what behaviours,
thoughts, etc. are moving her away from her values list.

I avoid talking to or seeing my mom

I order books online and take all online classes so I don’t have to see anyone

I have a few close friends that come over here for movie nights

I feel like people are always looking at me and judging me to be boring, or ugly

I don’t feel like I have anything to offer anyone

These items would go beside the left arrow. Now we have a current snapshot of what the person
values, and things they are currently doing or thinking that are moving them toward or away from their
values and the life they want to lead.

A two-fold approach

Now we need to do two things: Help her understand that her thoughts and feelings that are taking her
away from her values are “hooking” her, because she is listening to them and giving them power and
influence, and to develop some behavioural skills that she can practice that will lead her toward her
values. For her, this might include social skills training if she has difficulty starting and maintaining
conversations, giving her skills in resolving conflict so that she might find strategies to open up a
dialogue with her mother, etc. This goals/skills/training will be added to the right side of the diagram as
new behaviours leading her toward her values and the life she wants to lead.

Unhooking from the Negative Radio Station

Often, when people think about “unhooking”, they try to escape or avoid negative thoughts by actively
pushing them out of their mind. As you’ve probably experienced, as soon as you try to do this, you’ve
given that thought all kinds of power. Taking a step back, try to observe your thoughts as they come up,
much like you’re watching some kind of new reality show. Don’t try to stop them, don’t judge them, just
label them as “thinking” and observe them from a dispassionate place. If you start to get sucked in by
one of them, again, take on the role of observer or witness, and saying, “hmm, I notice that I’m thinking
this…” – this puts a little distance between you and the thought. Because ultimately, thoughts come and
go – just because they’re there, doesn’t make them true or worthy of being influential or taken
seriously. You can ultimately choose which of these thoughts have influence over you and which ones
you can readily dismiss as “brain chatter.” Part of the problem with “hooking” is that we identify with all
of our thoughts as though they’re real, and this gives them the power to influence our emotional states
and our behaviour. So approaching our thoughts from a place of observation and detached curiousity
allows us to remove ourselves (or unhook) from their influence. The better we get at doing this, the
more time and energy we have to devote to behaviours that commit to our values and the way we want
to live our lives. https://www.youtube.com/watch?v=gBT5ExDDwOg

Committing to Values-Based Behaviours

If you look at your values and some of the behaviours you’re already engaging in that are consistent
with or moving you toward your values, what other skills or behaviours would be helpful to implement
to move you even closer? Are there relationships you need to mend? Are there skill sets (job skills,
social skills, skills related to a hobby) that you need to learn? Where could you go to learn those skills?
Are there obstacles (financial, emotional, etc.) that get in the way of you acquiring those skills? Are
there ways around that? (For example, if you wanted to learn how to do pottery but didn’t have the
money to spend on classes, is there a local artist that might let you hang out and watch them and do a
little practice at their studio). Are there free groups in your community that help with substance abuse,
or social anxiety, or dealing with depression? Can you learn the skill by looking online? For example, I
wanted to learn how to make my own soaps, lotions, shampoo, etc. that were free of harmful chemicals,
so I used online tutorials and web-sites to learn everything I needed to know about how to do that. It
didn’t cost anything – and my first soaps were made from ingredients I already had. Once those
successfully sold, I was able to branch out a little more and buy different supplies and expand the
inventory. I’m sounding like an infomercial now, so I’ll stop, but the point is, many skills related to your
values can be acquired by being creative and reaching out. Start by choosing one or two behaviours you
could engage in to get closer to your values, and set a goal to try those. Engage a support network. By
unhooking from thoughts that lead you away from your values and committing to behaviours that lead
you closer to your values, those thoughts no longer have the ability to control or influence you, resulting
in better mental health and a life that is more fulfilling, meaningful and joyful.

Summary

As I mentioned earlier, this is by no means an exhaustive look at acceptance and commitment therapy. I
tried to distill the practice down to essential elements to get you started. If you want more information
about this technique, there are many web-sites, books and youtube videos devoted to the topic. Just a
reminder that there is an assignment attached to this learning unit. 