ACT I

INTRODUCTION TO ACCEPTANCE AND

COMMITMENT THERAPY

6 - 7 DECEMBER 2019

EMBASSY SUITES PHOENIX BILTMORE

PHOENIX, AZ

featuring

STEVEN C. HAYES, PHD

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Spencer Smith, Director
5674 Shattuck Avenue, Oakland CA 94609 USA
[email protected]

Dear friend:

Thank you so much for joining us for this Introduction to ACT workshop here in Phoenix with
Dr. Steven C. Hayes.
We’ve put together a schedule of trainings this year in cities across the country and have
hand-picked some of the best trainers we could find. Our trainers are not only experts in
their fields; they’re all excellent teachers, attentive and empathetic communicators, and they
really, really care about helping you help the people you serve.
PraxisCET offers:
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EMDR, Superhero Therapy, and much more
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You can always learn more about these projects at www.praxiscet.com.

I would like to extend a personal invitation to you today: PraxisCET is your company, serving
your practice community. To take care of you, we need to know what you need. I invite you
to let me know how we’re doing and what we can do better. You can reach me anytime by
email at [email protected].
Thanks very much for your support. I hope you have a great learning experience with us.

All the very best,

Spencer Smith

3
IMPORTANT INFORMATION
CHECK-IN / CHECK-OUT
• All attendee’s must sign-in in the morning when you arrive and sign-out in the
evening when you leave, regardless of CE status.
• Attendees must complete the course in full and attend all sessions in order to
receive ANY continuing education credit. No partial credit will be given.

HOW TO ACCESS YOUR CE CERTIFICATE

In order to print your CE certificate, you must first complete a workshop evaluation.
Please give us a 3 day grace period after the event has concluded before you attempt
to complete the evaluation.
• First, sign into your Praxis account at www.praxiscet.com/account.
• Click on the “My Workshop Evaluations” box.
• Choose the event you just completed and would like to complete the evaluation for.
• Click on “Feedback Survey” and complete the evaluation.
• Once the evaluation is submitted, you will receive an email with your CE certificate.
You can also access your CE certificate by going to the “My Certificates” page in
your Praxis account.
• Attendees have 6 months following the course to complete the workshop
evaluation and print your CE certificate. If you have not done so after the 6 month
mark, there is no guarantee that we will be able to provide you with a certificate.
Please email us at [email protected] for any additional help.

4
CONNECT WITH YOUR COMMUNITY ON US!

WITH ACBS MEMBERSHIP YOU GET

• A vibrant community including the ACT Listserv
• Local chapter involvement
• Special interest groups (SIGS)
• Access to the Journal of Contextual Behavior Sciences (JCBS) among other
resources

 Free 1 year membership provided by Praxis to first-time ACBS members

only. Renewals not eligible.

To take advantage of this subsidy, visit

www.praxiscet.com/acbs-membership

BOOK SALES newharbinger

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Workshop participants get 35% off

all titles at www.newharbinger.com
PLUS FREE STANDARD US SHIPPING
— THROUGH FRIDAY, 27 DECEMBER 2019 —

use code HAYAZ19 at checkout

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SCHEDULE

Friday, 6 December 2019

• 8:00 am – 8:30 am: Registration*

• 8:30 am – 10:15 am: -Welcoming & Orientation

-Defining Acceptance and Commitment Therapy
-Introducing Psychological Flexibility
-Introducing the Hexagon Model

• 10:15 am – 10:30 am: Morning Break*

• 10:30 am – 12:30 pm: -Defusion and Acceptance: Noticing Your Mind

and Opening up to Experience

• 12:30 pm – 2:00 pm: Lunch Break*

• 2:00 pm – 3:15 pm: -Self-as-Context: Inhabiting a Flexible Self

• 3:15 pm – 3:30 pm: Afternoon Break*

• 3:30 pm – 5:00 pm: -Values and Committed Action: Making Bold Moves
-Debrief
-Question and Answer

*Not available for CE

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SCHEDULE

Saturday, 7 December 2019

• 8:00 am – 8:30 am: Check-in*

• 8:30 am – 10:15 am: -Question & Answer

-Committed Action

• 10:15 am – 10:30 am: Morning Break*

• 10:30 am – 12:30 pm: -Contacting the Present Moment

-Bringing It All Together

• 12:30 pm – 2:00 pm: Lunch Break*

• 2:00 pm – 3:15 pm: -ACT for Clinically Relevant Concerns:

OCD, Trauma, Depression

• 3:15 pm – 3:30 pm: Afternoon Break*

• 3:30 pm – 5:00 pm: -Methods of Doing ACT: The Mindfulness Plan

-Final Question and Answer

*Not available for CE

7
Friday & Saturday | 6 - 7 December 2019 | 8:30 am ­– 5:00 pm

ACT I
Steven C. Hayes, PhD, is a Nevada Foundation Professor at the Department of
Psychology at the University of Nevada. An author of more than forty books and
nearly 600 scientific articles, his career has focused on an analysis of the nature
of human language and cognition and the application of this to the understanding
and alleviation of human suffering. Hayes has been president of Division 25 of the
American Psychological Association, the American Association of Applied and
Preventive Psychology, the Association for Contextual Behavioral Science, and of
the Association for Behavioral and Cognitive Therapies.

Disclosure of Relevant Financial Relationships

The Institute for Better Health, Inc. (IBH), formerly IAHB, is responsible for the content, quality and
scientific integrity of all CE/CME activities certified for credit. When an educational activity is offered for
medical (CME), Nursing (ANCC) and/or Psychology (APA) continuing education credit, participants must
be informed as to the source, amount, nature, and disposition of any funding used to support the activity,
whether in the form of educational grants, cash contributions, or in-kind contributions.
Individuals in a position to influence course content must also disclose whether they have one or more
relevant financial relationships with individuals and companies who have a financial interest in activity
content. All those in a position to control the content of an education activity are asked to disclose any
relevant financial relationships they have with any commercial interest.
Steven C. Hayes, PhD, has disclosed a relevant financial relationship with New Harbinger Publications/
Praxis and serves on the advisory board. Dr. Hayes agrees that his presentations and other contributions
to program content will be completely fair and unbiased, and will mention other healing processes and
productions during his presentations when appropriate. If possible, he will refer to generics rather than to
brand names when mentioning products, equipment, and services, and they will be selected/included on
the basis of best available evidence.

OFFICERS/PLANNERS
Spencer Smith, has no relevant financial relationships or conflicts.
Courtney Kendler, has no relevant financial relationships or conflicts.
Jen Demes, has no relevant financial relationships or conflicts.
Gerald W. Piaget, PhD has no relevant financial relationships.
Joan E. Piaget, MS has no relevant financial relationships.
Paresh Patel, MD, PhD has no relevant financial relationships.
Michael Freeman, MD has no relevant financial relationships.
Barbara Binkley, LCSW has no relevant financial relationships.
Maggie Allee, RN, BSN, MBA, JD has no relevant financial relationships.

Matthew McKay, PhD, has disclosed a relevant financial relationship with New Harbinger Publications/Praxis. Dr. McKay agrees that his pre-
sentations and other contributions to program content will be completely fair and unbiased, and will mention other healing processes and
productions during his presentations when appropriate. If possible, he will refer to generics rather than to brand names when mentioning
products, equipment, and services, and they will be selected/included on the basis of best available evidence.

Jacqueline Pistorello, PhD, has disclosed a relevant financial relationship with New Harbinger Publications/Praxis and serves on the advisory
board. In addition, Dr. Pistorello has contracted research which also includes research funding from the National Institute of Health. Dr. Pis-
torello agrees that her presentations and other contributions to program content will be completely fair and unbiased, and will mention oth-
er healing processes and productions during her presentations when appropriate. If possible, she will refer to generics rather than to brand
names when mentioning products, equipment, and services, and they will be selected/included on the basis of best available evidence.
Catharine Meyers, BA, has disclosed a relevant financial relationship with New Harbinger Publications/Praxis and serves on the advisory
board. Mrs. Meyers agrees that her contributions to program content will be completely fair and unbiased.
Kirk Johnson, has disclosed a relevant financial relationship with New Harbinger Publications/Praxis and serves on the advisory board. Mr.
Johnson agrees that his contributions to program content will be completely fair and unbiased.

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LEARNING OBJECTIVES
‰‰ Objective #1: Describe how to relate ACT to its foundational underpinnings
of Functional Contextualism, Relational Frame Theory, and Applied Behavior
Analysis

‰‰ Objective #2: Describe the six core processes of psychological flexibility/

inflexibility

‰‰ Objective #3: Demonstrate how to contact the present moment with flexible, yet
focused, attention

‰‰ Objective #4: Demonstrate how to access the observing process of self-as-

context

‰‰ Objective #5: Demonstrate how to cultivate compassion with the perspective-

taking process of self-as-context

‰‰ Objective #6: Demonstrate how to facilitate defusion from sticky cognitions

‰‰ Objective #7: Demonstrate how to foster acceptance of painful private

experiences

‰‰ Objective #8: Demonstrate how to construct and clarify values while

differentiating from goals

‰‰ Objective #9: Explain how to use creative hopelessness to motivate a change in

the control agenda

‰‰ Objective #10: Demonstrate case conceptualization and treatment planning with

the ACT Matrix while probing for toward moves (committed action) and away
moves (experiential avoidance)

‰‰ Objective #11: Explain how to formulate ACT-consistent informed consent, goal

collaboration, and therapeutic stance

‰‰ Objective #12: Demonstrate how to model, evoke, and reinforce psychological

flexibility within the therapeutic relationship

‰‰ Objective #13: Explain the concept of workability and how it informs the entire
ACT model.

We’re committed to making this the best training possible.

If you don’t feel that learning objectives have been achieved, please let the speaker know.

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A C T C H E AT S H E E T

ACT CHEAT SHEET

Welcome! What an exciting time it is to discover (or more deeply immerse yourself) in ACT! This ‘cheat
sheet’ is intended to give you a list of commonly used terminology in Acceptance and Commitment Therapy.
Keep this sheet handy for reference throughout your ACT learning experiences!

ACCEPTANCE & COMMITMENT THERAPY (ACT)

Acceptance & Commitment Therapy is abbreviated ACT and said aloud as a word ‘act.’ You may hear
ACT referred to as a therapy or a training, for instance: Acceptance & Commitment Training in applications
related to workplace/organizational practice or coaching. ACT is a model and not simply a method or set of
techniques, meaning you may be able to adapt ACT to clinical traditions and orientations that are already of use
to you. ACT is based on modern behavioral psychology, relational frame theory, acceptance and mindfulness
processes, commitment and behavior change processes.

TERMINOLOGY

ACCEPTANCE
Acceptance is an openness to private events (for example, anxiety, sadness, physical pain, etc.). In ACT,
individuals are encouraged to be accepting of their experience, rather than avoiding private events of anxiety,
sadness, or physical pain. To allow those sometimes difficult experiences, without defence to increase values
driven action, to do what is most important. Note that acceptance is not an end in itself, it is a part of a larger
whole, increasing psychological ßexibility.

THE ACT MATRIX

ACT has been presented visually in many ways including the hexaßex and the ACT matrix. The ACT matrix,
similar to the hexaßex, depicts the whole ACT model. The ACT matrix is drawn with two lines and a circle, which
divides the diagram into four quadrants: in the bottom right: values (or who and what is important to a person), in
the top right: committed actions (behaviors a person can be seen doing to move them toward who and what
matters), in the bottom left: difficult or painful inner experiences (these can be obstacles to moving toward who
and what matters), in the top left: avoidance behaviours (what a person can be seen doing to move away from
difficult or painful inner experiences). At the centre of the ACT matrix diagram is a circle, depicting the position of
psychological ßexibility, the stance ACT promotes for human functioning.


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A C T C H E AT S H E E T

COGNITIVE DEFUSION
Cognitive defusion is a process bringing awareness to: thoughts, the response to thoughts (all cognitive or
mental material), and the consequence of that response. Defusing invites openness to the effectiveness of the
response to thoughts, promoting engagement with a ßexible response to thought (rather than eliminating or
‘getting rid of’ thoughts).

COGNITIVE FUSION
When mental content like thoughts, memories, etc. (whether perceived as positive or negative) is strongly
believed or taken literally, this is considered an instance of fusion. Fusion is marked by a lack of awareness of
thoughts, memories, etc. where thoughts (or cognitive content) may appear to be ‘true’ or communicate
instructions/socially constructed messages. Cognitive fusion at its core, shows us one of the issues with
language. If cognitive fusion is perceived to be a problem (sometimes it can have positive outcomes), ACT
processes like acceptance and cognitive defusion can be helpful and useful to work with this content.

CONTEXT
Context is anything outside of the behavior being analyzed and can be referred to as the independent variable
(things that could be potentially changed, modiÞed, or manipulated). Examples of context include a personÕs
physical environment, social setting, or their education and learning history. All behavior occurs in a context.

CLINICALLY RELEVANT BEHAVIOR

Clinically relevant behavior (or CRB) is anything that a client does in the session that is 1) a problem 2) an
improvement in problem behavior, or 3) clients interpreting their own behavior.

COMMITTED ACTION
Committed action is about doing the behaviors/engaging in activities that are in the service of ones values (the
who and what is important). Examples of committed actions will look topographically different for all people, one
person sitting down to take time out of their day to have a nap or go to bed early may be a committed action for
one person, pursuant to values such as sleep management, sleep hygiene, taking care of oneself, whereas for
another person, sleeping may be functionally about experiential avoidance.

EXPERIENTIAL AVOIDANCE
Avoidance of experiences (experiential avoidance) is what a person does to minimize, escape, or move away
from thoughts, feelings, memories, physical sensations, and more. Experiential avoidance may create more harm
in the long-term and is understood to be sometimes pathological (or the opposite of psychological ßexibility) in
the ACT model. The justiÞcation for experiential avoidance being sometimes pathological, is simply that it can be
functional for a species to avoid some consequences, for example, my dog barking and running inside when a
coyote has stumbled into our neighbourhood is a functional consequence of experiential avoidance as my dog
may have a more dire outcome with the coyote if they had not run inside.

FUNCTIONAL ANALYSIS
Commonly presented in an A B C format, a functional analysis seeks to expose: A (Antecedent), B (Behavior),
and C (Consequence). This is a chain analysis of a persons difficulties, seeking to identify operant conditioning
or causal relationships. Notice that this way of looking at personal difficulties seeks to identify what may have
happened before a behavior or triggered a behavior. This antecedent could include a private experience such as
a thought, feeling, memory, or physical sensation, then seeks to identify the behavior that was operationalized,
and understand the consequences (outcomes) of that chain of action.

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A C T C H E AT S H E E T

FUNCTIONAL CONTEXTUALISM
Functional contextualism is the philosophy of science that is the underpinning to relational frame theory (RFT)
and ACT. In psychology, functional contextualists wish to gain knowledge for predicting and inßuencing behavior
(everything from observable behaviors like walking and talking to private behaviors like thinking or feeling).

HEXAFLEX
ACT is presented as a circular model with six common core processes: acceptance, defusion, contact with the
present moment (sometimes referred to as mindfulness), self-as-context, values, and committed action. The aim
of these six processes is to increase psychological ßexibility (depicted in the centre of the hexaßex). The hexaßex
is depicted below:

Although a hexagon is not circular, it is used to depict the six intersecting points of the processes. Essentially,
the six processes are all uniÞed making no one process more important than the other and each of the six are
entailed in one another.

PSYCHOLOGICAL FLEXIBILITY
Psychological ßexibility is the aim of the entire ACT model and psychological ßexibility can be seen as a model of
human functioning. Psychological ßexibility involves all of the six common core processes in the ACT model
(acceptance, defusion, contact with the present moment, self-as-context, values, and committed action)
combined. Essentially, ACT aims to strengthen or increase psychological ßexibility.

Conceptually, it may be helpful to view this model circularly, as in how it is presented in the hexaßex.
Alternatively, we can imagine that psychological ßexibility is a series of interrelated processes that are active in
conjunction with one another, for example a psychologically ßexible person may say their experience of the
world is: “I am here now, accepting the way I feel, and allowing my thoughts, while committing to, what I care
about.Ó This could be a person who is in contact with the present moment even with difficult thoughts, emotions,
memories, etc.

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A C T C H E AT S H E E T

RELATIONAL FRAME THEORY (RFT)

As the theoretical underpinning to ACT, Relational Frame Theory (RFT), a psychological theory hypothesizes that
language, thoughts, and all other cognitive content is something someone does. RFT explains that deriving
stimulus relations is a learned operant. More simply, human beings have the ability to learn to make connections
that are not easily perceived or apparent.

A derived stimulus relation could be as simple as stating that ‘a dime is bigger than a nickel’ (although physically
a nickel is larger in size, this is apparent, less explicitly a nickel is valued less than a dime as currency, therefore
one could say something seemingly incorrect based on physical size alone, such as a dime is bigger than a
nickel). Deriving stimulus relations does not end with physical objects, humans can also apply this verbal and
cognitive behavior too (like thinking).

SELF-AS-CONTEXT
Self-as-context is one of the six processes in the ACT model, similar to present moment awareness or
mindfulness, self-as-context encourages a noticing of thoughts. However, self-as-context as a process, separate
from mindfulness invites people to see themselves as separate from their thoughts/content that happens
privately (private behaviors or cognitive activity).

Seeing oneself as the context upon which thoughts or other private experiences happen and not the content or
the experience itself is one of the helping elements of the ACT model. It is in this way that self-as-context allows
a person to see themselves as a stable entity, an observer of their experience, and the experienced content
(private, cognitive, etc.) as changing.

MINDFULNESS & PRESENT MOMENT AWARENESS

ACT promotes a mindfulness that orients people to present moment awareness, the here and now. Mindfulness
is one of the six processes in the ACT model, it promotes an awareness of thoughts, feelings, and sensations).
Note here that ACT simply invites the observation of these experiences, if judgements arise, this approach to
mindfulness would also regard judgement as yet more private experiencing/content to be mindfully observed.

Mindfulness can be practiced formally in a variety of methodologies from meditation or ‘mindful activities’ such
as mindful walking, mindful eating, yoga, and other contemplative practices. Some of the techniques that could
be used to demonstrate other processes in the ACT model, such as acceptance, defusion, self-as-context,
values, and committed action may take on some similar form to a mindfulness exercise or involve mindfulness as
an activity. This is not uncommon in the ACT model, as mindfulness appears to be spread throughout the
processes. One could create an exercise based on clarifying values that involves mindful observation.

VALUES
Simply the who and what that personally matters to an individual, values are uniquely chosen principles or
standards. For example, being a loving partner may matter to one person who also states that their partner is
important to them. For another person, they may state that athleticism is important to them, that taking care of
their body and increasing their skill level is what they value. In both examples, the value of who or what is
important has been clariÞed. Values go beyond goals, not simply telling a partner you love them or performing
well at an athletic event. Values are a sort of beacon that never simply is accomplished.

Turning a value into an adverb often helps clarify the continuous advancement toward that chosen meaningful
areas in ones life.

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WHAT’S COMING UP NEXT...
For more information or to register for a live event or online course, visit
www.praxiscet.com

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PhD, BCBA-D, and Alyssa Wilson, PhD, BCBA-D February 20-23, 2020
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