Acceptance and commitment therapy

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The Acceptance and Commitment Therapy (ACT spoken, like the English word act ) is a newer form of psychotherapy in which classical behavioral techniques with mindfulness and acceptance-based combined strategies and interventions to values clarification. The therapeutic approach was largely from the American psychologist Steven C. Hayes developed and is based on the reference frame theory (Theory Relational Frame), a contextualist explanation for language-thought processes, which is a further development of behavioral analytical explanations skinnerscher represents embossing.

Basics

In the ACT, it is assumed that the following psychological processes contribute to the development of psychological disorders: lack of separation between language or thinking on the one hand and reality on the other ("cognitive fusion"), avoidance of experiences, narrowing of thoughts (with brooding and overvaluation of thought processes) , Lack of values ​​and cherished actions and a lack of commitment to oneself (inner self-commitment). A distinction is made between “clean” and “dirty suffering” for the problems that burden the patient. "Dirty suffering" arises from the attempt to avoid unpleasant inner experiences ("experiential avoidance") with the help of various strategies (withdrawal, escape, anesthesia, arguing, excessive security behavior, tension-reducing rituals, etc.). The strategies used not only have the disadvantage that they do not work or only work for a limited time, but are also associated with considerable negative consequences for the patient's lifestyle.

The therapeutic goals of this form of therapy include: acceptance, mindfulness, a “cognitive defusion”, the perception of the self as one's own transcendental quality, as well as an alignment of one's own actions with self-chosen values. Therapy consists mainly of helping the patient to break down his dysfunctional attempts at control by increasing his willingness to experience unpleasant sensations “for what they are, not what they claim to be,” as ACT does -Therapists often express. For this purpose, different techniques are used, some of which are borrowed from Buddhist meditation practices and the repertoire of methods of other therapeutic schools (e.g. Gestalt therapy ). A lot of room in therapy based on the ACT model is the clarification of values ​​and life goals, from which concrete intentions for action (commitments) are derived.

As with other approaches to cognitive behavioral therapy, work is done on dysfunctional thoughts. However, no attempt is made to change the content of the thoughts (for example to replace “negative” with “positive” or “irrational” with “rational” thoughts). Such attempts, as can also be deduced from the Relational Frame Theory , often only lead to a strengthening of the underlying "frame of reference" - with the effect that the corresponding thoughts in intensity and frequency increase. Rather, the attempt is made to modify the function of the cognitive reactions by the patient learning techniques that enable him to contemplate his own thoughts calmly (“mindfully”) without “merging” with them, ie without being inevitable Align behavior with them.

In the ACT, techniques of behavior therapy, hypnotherapy and meditation are used.

application

ACT is used for a number of disorders and problems and has been studied several times with regard to its effectiveness. For example, studies are available on the treatment of people with psychotic symptoms, social anxiety, symptoms of depression and anxiety, borderline personality disorder or diabetes . The published findings suggest that ACT may be at least as effective as other empirically examined established therapies, such as cognitive therapy according to Beck .

admission

The basic ideas of ACT and the procedures have met with great interest, especially in the USA, Australia and in some Western European countries (e.g. the Netherlands, Spain, Switzerland and the Scandinavian countries). Numerous books have been published, both those aimed at experts and books for people with certain mental health problems such as: B. Eating disorders , post-traumatic stress , chronic pain or burn-out .

literature

  • Georg H. Eifert: Acceptance and Commitment Therapy (ACT) . Hogrefe Verlag, 2011, ISBN 978-3-8017-2215-9 .
  • Russ Harris: ACT made simple - An Easy-to-Read Primer on Acceptance and Commitment Therapy. New Harbinger Press, Oakland, CA 2009, ISBN 978-1-57224-705-5 .
    • German translation by Cornelia Eder: ACT made easy. A fundamental guide to the practice of acceptance and commitment therapy . Arbor Verlag, Freiburg 2011, ISBN 978-3-86781-031-9 .
  • Russ Harris: If you run after luck, you will miss it - a book of rethinking. Kösel-Verlag, Munich 2009, ISBN 978-3-466-30820-0 .
  • SC Hayes, KD Strosahl, KG Wilson: Acceptance and commitment therapy: An experiential approach to behavior change. Guilford, New York 1999.
    • German translation by Rainer Sonntag: Acceptance and Commitment Therapy. An experiential approach to behavior change. CIP-Medien, Munich 2004, ISBN 3-932096-37-1 .
  • SC Hayes, KD Strosahl (Ed.): A practical guide to acceptance and commitment therapy. Springer, New York 2004, ISBN 0-387-23367-9 .
  • SC Hayes, Jason Luoma, Robyn D. Walser: ACT training. Handbook of Acceptance & Commitment Therapy. Junfermann Verlag, Paderborn 2008, ISBN 978-3-87387-700-9 .
  • SC Hayes, S. Smith: In Distance to the Inner Word Machine: A Self-Help and Therapy Guide Based on Acceptance and Commitment Therapy (ACT). Dgvt-Verlag, 2007, ISBN 978-3-87159-069-6 .
  • T. Heidenreich, J. Michalak (Ed.): Mindfulness and acceptance in psychotherapy. A manual. DGVT-Verlag, Tübingen 2004, ISBN 3-87159-060-6 .
  • N. Klingen: ACT - Acceptance and Commitment Therapy: Your life is more important than your fear (PDF; 289 kB). In: daz German fear magazine. Munich, 2010.

Individual evidence

  1. ^ SC Hayes, D. Barnes-Holmes, B. Roche (Eds.): Relational Frame Theory: A Post-Skinnerian account of human language and cognition. Plenum Press, New York 2001.
  2. ↑ a b c Chapter IV.24 Behavioral Therapy by Frank Schwärzler and Martin Hautzinger, pp. 400–410. In: Siegfried Kasper, Hans-Peter Volz (Hrsg.): Psychiatrie und Psychotherapie compact: The entire specialist knowledge , Thieme, 2014, ISBN 978-3-13-156903-5 , section Acceptance and Commitment Therapy (ACT), p 408 .
  3. ↑ From the field of hypnotherapy are used: "Metaphors, therapy stories". Quoted from Chapter IV.24 Behavioral Therapy by Frank Schwärzler and Martin Hautzinger, pp. 400–410. In: Siegfried Kasper, Hans-Peter Volz (Hrsg.): Psychiatrie und Psychotherapie compact: The entire specialist knowledge , Thieme, 2014, ISBN 978-3-13-156903-5 , section Acceptance and Commitment Therapy (ACT) , p 408.
  4. ↑ P. Bach, SC Hayes: The use of Acceptance and Commitment Therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. In: Journal of Consulting and Clinical Psychology. 70 (5) 2002, pp. 1129-1139.
  5. ^ KL Dalrymple, JD Herbert: Acceptance and Commitment Therapy for Generalized Social Anxiety Disorder: A pilot study. In: Behavior Modification. 31, 2007, pp. 543-568.
  6. ^ EM Forman, JD Herbert, E. Moitra, PD Yeomans, PA Geller: A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and Cognitive Therapy for anxiety and depression. In: Behavior Modification. 31 (6) 2007, pp. 772-799.
  7. ↑ KL Gratz, JG Gunderson: Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. In: Behavior Therapy. 37 (1) 2006, pp. 25-35.
  8. ^ JA Gregg, GM Callaghan, SC Hayes, JL Glenn-Lawson: Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. In: Journal of Consulting and Clinical Psychology. 75 (2) 2007, pp. 336-343.
  9. ^ M. Heffner, GH Eifert: The Anorexia Workbook: How to accept yourself, heal suffering, and reclaim your life. New Harbinger Publications, Oakland, CA 2004, ISBN 1-57224-362-7 .
  10. ↑ VMFollette, J. Pistorello: Finding Life Beyond Trauma. New Harbinger, Oakland, CA 2007, ISBN 978-1-57224-497-9 .
  11. ^ J. Dahl, T. Lundgren: Living Beyond Your Pain. New Harbinger, 2006, ISBN 1-57224-409-7 .
  12. ↑ M. Waadt, J. Acker: Burnout - Breaking the vicious circle with acceptance and mindfulness. Hans-Huber-Verlag Bern, 2013, ISBN 978-3-456-85082-5 .