Steven C.Hayes – ACT in practice 2022

Create a guiding framework for effectively using
acceptance and commitment therapy to cultivate lasting change

From the desk of Dr. Steven C. Hayes
Reno, Nevada

Dear friend,

By any standard, practitioners have a tough job.

Working in close quarters with human suffering — especially today — is an undeniably challenging task.

But in return we get to be part of something uplifting:

Helping others pivot toward purpose, experience, and life.

We’ve seen how acceptance and commitment therapy (ACT) can help us with this undertaking.

By allowing us to foster better therapeutic relationships, ACT makes our work even more engaging and meaningful.

In targeting the six core processes that underlie human behavior, it gives us the ability to address a vast range of problems and help almost any client.

And the best part is: we see that it works.

We see it in the person who chose to enjoy life while living with an irreversible physical ailment, or the client who found the courage to change careers late in life, or someone who finally faced their anxiety in order to be present for their family.

Having a hand in that success is not only an immense privilege, but an empowering experience.

But for many practitioners, these seamless, dramatic triumphs are rare.

Far more common are moments of uncertainty, when progress has stagnated and turning principles into transformation feels beyond reach.

It’s one thing to know the ACT model and its principles in the abstract.

It’s another to implement them in a way that’s impactful and organic, especially when you’re sitting across from a challenging client and the clock is ticking.

With clients who seem disengaged and resistant to change, or cling to goals of diminishing “bad” feelings, the way forward is often unclear.

In these scenarios, the theory might make perfect sense to practitioners conceptually . . .

But when it comes to applying ACT, they’re less confident.

Self-doubt creeps in, and they hesitate to make their next move, questioning if it’s the best one to guide the client toward meaningful progress.

And unlike the masterful sessions clinicians see in workshops, many of them instead share experiences like the following:

• They work comfortably with acceptance and defusion, but struggle to find the right exercise to target self-as-context, so avoid it in sessions

• They sometimes feel like teachers instead of therapists, relying on lecturing to introduce concepts instead of weaving experiential exercises naturally into sessions

• They feel stuck when it comes to challenging clients, unsure of how to move forward or make their sessions as valuable as possible

• They hesitate to push certain clients to engage with difficult thoughts or feelings for fear of demotivating them further, but end up on different pages about their therapeutic aims

• They approach sessions with rigid ideas about what should happen next rather than being able to respond flexibly to the moment

Experiences like these are surprisingly common among ACT practitioners.

Even skilled clinicians can feel uncertain when tailoring treatments for particularly difficult clients — especially without resorting to cookie-cutter interventions.

But why is this the case, when we know the model and have seen it work?

The answer goes beyond simply practicing more of the same, into something at the heart of this method.

In recent work, my colleague Dr. Stefan Hofmann and I have refined certain conceptualization and treatment methods and put them into a process-based application framework.

Using these tools, we can understand our clients more deeply throughout the therapeutic relationship, from an ACT perspective.

And, most importantly, we can more easily find opportunities for intervention.

To help us organize this perspective, we can use a modified version of client-based network diagramming.

Network diagrams allow us to gain a holistic understanding of a case

Using network diagramming as a foundation, we can perform a process-based form of assessment to flesh out the relationships between case features in a way that shows us how and why pathologies are retained within a specific context.

We can also use this analysis to identify where processes of change overlap with maladaptive behavior patterns.

This process helps us see what we should target for long-term success and map out a plan to do so, again using network diagramming to organize the strategy.

Together, the tools within this new framework allow us to develop a clearer understanding of client cases and execute effective, tailor-made therapies — all in a way that’s firmly grounded in ACT principles.

Human lives are not composed of a few events laid out in a linear fashion. So despite our best efforts, approaching therapy in that way can lead to a dead end.

Still, linear thinking is so ingrained in our training and culture that a flexible approach can feel abstract if it is not guided by practical tools.

With the tools inside our process-based framework, we can instead see how underlying processes cause behavior to reinforce and amplify itself in loops.

By using this framework to gain a non-linear perspective of a client’s case, you can develop a more nuanced understanding of their behavior and make a better plan to intervene.

When you’re struggling to apply ACT principles in-session, it’s difficult to know how to intervene in the moment and at the same time know that it’s tied to long-term success.

A process-based framework allows you to clearly see behavior patterns within the whole context that retains them. Because of this, you will have a holistic understanding of the case and will see more opportunities to intervene if an attempt falls flat or you simply hit a wall in therapy.

By expanding the focus, I discovered a fused self-image, only noticeable at work, that she was “likely to break under pressure.” After employing self-compassion and defusion work focused on this sense of self, she was then able to work on vulnerability in relationships.

In other words, this framework allows you to approach therapy like a game of chess:

Instead of thinking one move at a time, you’re visualizing a way to win the whole game.

Rather than offering a formula or protocol, this process-based framework gives structure to therapeutic aims throughout our journeys with clients:

It gives you a clearer sense of what to ask during intake to better understand a case.

It allows you to map the psychological flexibility model onto case features and find the best opportunities for intervention.

It helps you plan treatment based on what is most likely to work for that specific client.

I saw values as an endpoint, missing that the client would need mindful attentional skills to know when to act on those values and to recognize progress in building values-based habits. By focusing more on attentional skills, the ability to sustain a positive outcome felt much more likely.

These gaps are typically the hardest thing to see in a case, but with a process-based framework, we can more easily identify them and shift our approach.

Once you understand how to use the tools within this framework, you’ll come to your very next session with a clearer pathway in your head and the psychological flexibility model built right into it.

That way, you’ll be able to more strategically bring about lasting change.

I hope you’re starting to understand how this expanded process-based framework can help you ground ACT theory in practical application so you can implement it more creatively, confidently, and effectively.

Seeing this framework in action and practicing it yourself is the best way to learn how to apply it in your own sessions.

And that’s exactly what I’m about to share with you.

Below are all of the details about my online course that builds on what you already know about ACT, teaches you practical tools for applying it, and shows you how to put them to work in sessions.

Inside, we’re going to bring the philosophical visions of process-based therapy down to things like how to do an intake, how to do a different kind of diagnosis, how to do a functional analysis, how to design a treatment, and how to face other challenges presented in your daily work.

Along the way, you’ll learn practical skills and tools to help you more effectively bring about positive change for your clients.

Dr. Steven C. Hayes, the originator of acceptance and commitment therapy and one of its key co-developers, is a Nevada Foundation Professor in the Behavior Analysis program at the Department of Psychology at the University of Nevada, Reno.

His work has been celebrated with several awards, such as the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies and the Impact of Science on Application Award from the Society for the Advancement of Behavior Analysis.

With 46 books and nearly 650 scientific articles published, Dr. Hayes is one of the most cited psychologists in the world as he continues to innovate in the field of psychology.

Deepen and empower your work in acceptance and commitment therapy with Dr. Steven C. Hayes, a visionary co-founder of ACT and the Contextual Behavioral Science movement.

In this online course, you’ll gain access to a new, process-based framework designed to help clinicians who have a solid ACT foundation bridge the gap between theory and practice. You’ll watch Dr. Hayes apply this framework in extensive roleplay sessions and real plays — authentic, unscripted conversations with clinicians about their lives. And you will see his thought process from start to finish as he builds network diagrams, performs functional analysis, makes reads, and plans and implements treatment.

Equipped with this insight, you’ll be able to develop a clear pathway for implementing ACT throughout your therapeutic relationships — and become more effective at cultivating prosperity in the lives of your clients.

In this online training, you will learn about some of the most recent and important developments in all of evidence-based therapy, with an emphasis on seeing them in action so you can put them directly to use in your own practice.

ACT in Practice combines video instruction and exercises with some of the most extensive footage available of an expert applying the psychological flexibility model in strategically designed roleplays and real conversations with healthcare professionals working on personal issues.

In this way, the course offers both a more advanced ACT experience as well as a highly practical approach.

Course content and materials are in English, and all videos will include subtitle options in English and Spanish.

The example sessions were all conducted remotely, via video call. So you’ll get a chance to see how you can fully engage clients using this expanded framework, even completely online.

Using tried-and-true ACT methods, such as skills exercises, alongside cutting-edge tools, you’ll learn how to gain a deeper understanding of even the most complex cases, make more accurate reads, plan targeted interventions, and apply the Hexaflex model with greater confidence and flexibility.

ACT in Practice is a self-paced, entirely online course.

The 10 modules will be released at a rate of one module per week so you’re able to fully absorb the material before moving on.

However, you’re also welcome to work through the modules more gradually as your schedule permits. With lifetime access to all course material, you will be able to revisit it anytime in the future, including any future updates that are made to the course.

The first 3 modules introduce you to a new, process-based framework that will allow you to apply ACT theory with creativity and confidence.

From the very beginning, you’ll complete exercises to put this framework, and the tools within it, into practice. You’ll also watch Dr. Hayes apply it in three important stages of the client relationship: doing an intake and building a preliminary network diagram, performing a new form of process-based functional analysis, and planning and implementing treatment.

In Modules 4 through 6, you’ll view roleplays with different clients covering work from all corners of the Hexaflex model and will hear Dr. Hayes explain why he made certain choices at critical moments.

Module 7 will focus on how to move to any point on the Hexaflex at any moment and do effective work — even with challenging clients.

In Modules 8 and 9, you’ll hone and test your skill in reading clients’ psychological flexibility, as well as in identifying the processes a therapist is targeting in session.

You’ll conclude the course with Module 10 by improving your ability to discern adequate, good, and excellent ACT interventions, using Dr. Hayes’s example session for practice, which will ultimately make you more effective in your own work.

In the last two modules, you’ll also benefit from the insight of Dr. Robyn Walser and Dr. Kelly Wilson, two of the world’s leading ACT experts, who collaborated with Dr. Hayes for written exercises and a point-by-point discussion of a real play. This will give you an opportunity to measure your skills more objectively while also learning from additional world-class practitioners.

• Develop a deeper understanding of your clients from the very first session, so you can plan and implement treatment more effectively with holistic aims in mind
• Access a broad range of exercises, metaphors, and interventions that can help you create experiential learning in sessions rather than resorting to lecturing
• Hone your ability to make accurate reads and identify client strengths and weaknesses as well as opportunities for meaningful work
• Always have a full grasp of your client’s entire case and how issues are being retained, so you can move flexibly between processes and maintain a clear sense of direction
• Understand how to use the psychological flexibility model as a framework for incorporating other important processes and interventions in evidence-based therapy

After completing these 10 modules, you will have the practical skills and tools to be more effective in your very next intake.

• How a process-based framework offers a better way forward than previous efforts to categorize and treat psychological disorders
• The guideposts you can follow throughout the client relationship to better understand someone’s case, choose interventions, and measure outcomes
• Start building the practical skills needed to visualize a client’s case clearly
• See Dr. Hayes’s thought process as he walks you through creating a preliminary network diagram for Mariana, a roleplay client dealing with a history of abuse and struggling to find joy and connection in life
• Draw your own preliminary network diagram based on a case study of Stan, a father experiencing debilitating anxiety that impacts his relationship with his family

• Turning functional analysis into an effective treatment plan that fits with a client’s goals for therapy
• How to disrupt maladaptive behavior patterns within a case and turn them into self-sustaining adaptive loops that will last even after your work with a client ends
• Review an emotional approach to creative hopelessness for Mariana, a strategy that can be used with clients who are resistant to change
• Watch as Dr. Hayes creates a treatment plan diagram for Mariana and shares his thought process
• Based on your functional analysis diagram from Module 2, draw a treatment planning diagram that helps you map out impactful interventions for Stan

• Review psychological flexibility reads and interventions related to touching the “now” and sense of self
• How to move these processes indirectly through other corners of the hexagon in order to expand your flexibility during sessions
• View a 3-part roleplay with Sally, a client experiencing depressed mood as she flounders without a sense of purpose in retirement
• See Dr. Hayes taking a psychoeducational approach to creative hopelessness within the roleplay
• Examples of how to successfully implement present moment exercises and the “devil’s advocate” approach to clarifying values

• How hexadancing works and why it can be a useful approach to implementing ACT
• See hexadancing used effectively in a real play session with a clinician who longs to connect more deeply with his wife and community
• Understand the importance of extending flexibility processes out socially, and see a demonstration of how it’s possible
• How ACT work fits into the larger arc of mindfulness, acceptance-based approaches, and contemplative practice
• Complete 3 exercises in which you’re presented with progressively more challenging statements from clients and must decide on appropriate ACT responses, which you can then compare with Dr. Hayes’s answers and explanations

• Watch a real play in which Dr. Hayes works with a man who feels stuck when it comes to caring for his health
• Assess your skill in reading psychological flexibility processes, as well as discerning which processes Dr. Hayes is targeting, using the real play transcript
• Compare your answers to those of Dr. Hayes and Dr. Robyn Walser, another premier ACT expert, to help you objectively identify areas for improvement
• Learn from Dr. Hayes as he explains what he was observing and thinking during the example session
• Ultimately, become more proficient in making accurate reads so you can apply ACT more confidently and respond flexibly to what comes up in sessions

• ACT Assessment Toolkit – Dr. Hayes’s curated list of the simplest short clinical assessment tools, ready for downloading to use with clients
• Single-item Assessments – A list of single-item measures that you can download as a Google Doc and tailor to create individualized assessment questionnaires for clients
• Targeted Assessment Tools – A range of tools for specific client populations and issues (e.g., cancer, chronic pain, smoking, weight issues), ready for downloading to use with clients
• ACT Rating Scale Training Manual – A guide to using the objective scale for rating therapist efficacy developed by Dr. Robyn Walser and Varvara Mazina

Because ACT deals with nearly universal human yearnings, it is compatible with many other modalities. But when you’re working on complex issues, it can be challenging to effectively apply other methods to the flexibility processes.

To help you find a cohesive approach, you will have access to a training session on integrating ACT with other methods for more flexible, impactful work.

In the webinar, you will learn:

• How popular modalities like CBT, DBT, and relational psychodynamic methods can empower work on psychological flexibility, and vice versa
• How to mix and match disciplines and still have a coherent approach
• Potential conflicts to look out for when overlapping techniques
• And more…

The growing shift toward teletherapy is giving us a wonderful opportunity to expand our work. Still, there are considerations in terms of how to facilitate engaging, powerful clinical sessions across that space.

In this recorded webinar, Dr. Hayes talks about what we are learning about teletherapy best practices, and how his experience making ACT in Practice taught him a few fine points.

You will learn:

• How to navigate the unique challenges of remote therapy
• Strategies for increasing your own psychological flexibility around teletherapy, as well as your clients’
• The surprising benefits offered by this format, and how to take advantage of them
• And more…

When you enroll in the course, you get lifetime access to all course materials.