Getting my ‘ACT’ together

Since learning about Acceptance And Commitment Therapy (ACT) I have tried to incorporate this into my routine. I have struggled with my mental health in the past (you can read about this in my previous blog for World Mental Health Day). ACT has been shown to have positive impact on mental health issues and symptoms of depression (Bohlmeijer et al, 2011, Livheim et al 2015).

Last week I realised a great example of how I am able to incorporate many of these ACT principles into a 30-60 minute walk during my lunch break. Here I will share my thoughts with you.

IMG_20190708_123243_020
Picture taken by Kirsty Angel BCBA

Firstly, let’s quickly cover the main areas within the ACT framework:

  • Defusion: Fusion with negative thoughts can be difficult to cope with.
  • Contact with the present moment: Contact with the present moment, and spending less time ruminating
  • Values: Thinking about what is important to you to help you lead a meaningful life. These are different to goals,
  • Committed Action: Engaging in behaviours that lead to your values.
  • Self as Context: This means having an understanding of who you are. I am a daughter, a sister, a runner, a Behaviour Analyst, a friend, etc..
  • Acceptance: This involves accepting that negative feelings are natural part of everyday; worry, anxiety, sadness and anger are normal part of life.

If you want to learn more about these visit the previous ACT blog I wrote.

When I spend a full day tutoring I like to make sure I go out for a walk on my lunch break (weather permitting). I really enjoy taking the time out and this feels like a great opportunity for some self-care. If you are a tutor, and you’re like me, you usually have more than one client per day and you spend your lunch break driving and quickly eating your lunch. So when I get the opportunity to go out for a break, then I make sure I take the opportunity to get out.

20190708_123523
Picture taken by Kirsty Angel BCBA

How does this relate to ACT? There’s a variety of ways. One of my main motivations is health and fitness. A friend and I will regularly have competitions throughout the week to see who can do the most steps (through fitbit App). Being healthy and fitter is a value of mine (I run regularly), and the competition helps me keep active throughout the week. The competition helps me stay motivated as I like a good competition. The NHS (May 2018) recommend daily activity to people aged between 19-64, as this is associated with improved health and lower risk of illness, diseases and mortality (Biswas, et al 20). You can see the data below for our first day:

 

Although I run 3 or 4 times a week, I still like to stay active outside of my running. Also, our job can be very sedentary, so getting up and moving about is always a good idea.  Research has shown that there may be a link between being sedentary and poor health outcomes, although there is an association with decreased risk and higher levels of activity as opposed to lower levels of activity.  (Biswas et al, 2015), so taking this walk helps me take committed action towards my value of health.

This is also a great way to be in the present moment. I discovered these lakes and paths (in the pictures above and below) by accident recently, which may not have happened if I had been in my own thoughts and not present, because I would have missed the footpath sign, which was tucked away by a bridge alongside a house! It is such a beautiful place to go and walk around. This also means I take committed action towards my value of having good mental health. Being present and mindful is a skill that can be practised. You can find a great activity that fit with your interests or schedule. Being mindful has been shown to has positive relationship with good mental health (Hofmann et al, 2010).

20190708_123807
Picture taken by Kirsty Angel BCBA

In addition to this, being mindful (and in the present moment) have positive impact on staff well-being. Practitioners who work with children or adults with developmental disabilities who use ACT decrease in distress (Bethay et al, 2013). In addition, mindfulness practise by staff has been shown to reduce the use of restraint (Singh et al 2009). I don’t regularly use physical restraint during my work, but the researchers suggest that the clients of the participants (the staff using mindfulness)  in this study “may have reacted positively to changes in staff behaviour”. Engaging in mindfulness may have a positive impact on my interactions with my own clients, making my sessions more meaningful. This is in line with my value of being an effective Behaviour Analyst.

 

How do you use ACT in your life?

Feel free to contact me about this blog, or leave a comment below!

 

References and further reading

Bethay, J. S., Wilson, K. G., Schnetzer, L. W., Nassar, S. L. & Bordieri, M. J. (2013). A Controlled pilot evaluation of Acceptance and Commitment Training for Intellextual Disability Staff, Mindfulness, 4, 113-121.

Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., Alter, D. A. (2015). Sedentary Time and its association with risk for Disease incidence, mortality and hospitalization in adults, Annals of Internal Medicine, 162, 123-132.

Bohlmeijer, E. T., Fledderus, M., Rokx, T.A.J.J, Pieterse, M. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology, Behaviour Research and Therapy, 49, 62-67.

Clarke, S., Kingston, J., James, K., Bolderston, H., Remington, B. (2014). Acceptance and Commitment Therapy group for treatment-resistant participants: A randomized controlled trial, Journal of Contextual Behavioral Science. 3, 179–188

Hofmann, S. G., Sawyer, A. T., Witt, A. A. & Oh, D. (2010). The effect of mindfulness-based therapy on Anxiety and Depression: A meta-analytical review. Journal of Consulting and Clinical Psychology, 78(2), 169-183.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford.

Hayes, S. C.,  & Wilson, K. G. (1994). Acceptance and Commitment Therapy: Altering the Verbal Support for Experiential Avoidance, The Behavior Analyst, 17(2), 289-303.

Livheim, F., Hayes, L., Ghaderi, A., Magnusdottir, T., Hogfeldt, A., Rowse, J., Turner, S., Hayes, S. C., Tengstrom, A. (2015). The Effectiveness of Acceptance and Commitment Therapy for Adolescent Mental Health: Swedish and Australian Pilot Outcomes. Journal of Child and Family Studies, 24, (1016-1030)

NHS, (2018, 11, 20). Moodzone: Mindfulness, retrieved from https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/

NHS, (2016, 05, 30). Exercise: Physical activity guidelines for adults, retrieved from https://www.nhs.uk/live-well/exercise/

Tourinho, E. Z. (2006). Private Stimuli, Covert responses, and private events: Conceptual remarks, The Behavior Analyst, 29(1), 13-31.

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