Acceptance and

Commitment Training (ACT)

in the Workplace
A Three-Session Protocol

Dr. Paul Flaxman

City University London
11th March 2011
 Acknowledgements
Funders

• City University Staff Development Unit

• Economic and Social Research Council
• Guy‟s and St. Thomas‟ Charity
Collaborators
• Prof. Frank Bond
• Jo Lloyd
• Mia Soderberg
• Dr. Vasiliki Christoloudou
• Dr. Matthew Wardley
• Dr. Joe Oliver
• Eric Morris
 Presentation Overview

• Background
Evolution of the ACT at Work protocol
Why the workplace is a good place for ACT

• Overview of the three sessions

• Adopting the ACT stance

• Implementation issues Q&A

 Evolution of the ACT at Work Protocol

How I got started:

ACT working manual (1995); Frank‟s ACT for stress protocol; ACT
book (1999)

How can I
How can I translate this
This stuff
make it for the
is
my own? general
confusing
public?
 Evolution of the ACT at Work Protocol

2002-2004: Three-session ACT training for local council

employees (N ~ 500+)

2007-2008: Brief ACT sessions for Central Government

employees (N ~ 60)

2008-2009: One day ACT sessions for University staff and students
(N ~ 200)
2009-2010: Updated three-session ACT for NHS and
central government workers (N ~ 250)

2009: Commissioned by New Harbinger to publish three-

session protocol
 Why the workplace is a
good place for ACT

1 in 6 UK workers experiencing a common mental

health problem at any one time…..
75% of whom do not receive psychological
intervention (Seymour & Grove, 2005)

Let’s take the interventions to

them!
 Why the workplace is a
good place for ACT

Presenteeism costing businesses „1.5 to several

times‟ more than absenteeism (Sainsbury Centre,
2007)

Helping people function better

while experiencing difficult
private events
 Why the workplace is a
good place for ACT

Experiential avoidance viewed as a basic

vulnerability factor (or ‟transdiagnostic‟ process)

Workplace highlighted as a viable

context for preventive intervention
(Biglan et al., 2008)
A Three-Session Protocol
 My ‘top tips’
• Don't try to do too much – less is sometimes
more (cf. Richardson & Rothstein, 2008)
• Use simple organising strategies (e.g., two core skills;
Passengers on the Bus)

• Do away with the „gloss‟ – let the processes sell

themselves and allow your humanity to shine through!

• Focus on cultivating the 6 core processes, rather

than any strict ordering of techniques

• Use humour
 Session 1 – Opening

• Hopes and expectations

• Ground rules (confidentiality etc)
• Other support available
• Training, not therapy

• Importance of attending all sessions

• Introduction to the training….

Introduction

MINDFULNESS
Present moment awareness training
Untangling from difficult thought and emotion
Finding your resilient sense of self

VALUES-BASED ACTION
Clarifying your most valued life directions

Using values as a guide to goals and daily

behaviour
 Introduction
RATIONALE (each point open to discussion)

• Humans are dealing with two worlds:

inside the skin and outside the skin

• We can sometimes become overly

„entangled‟ with particular thoughts and feelings

• „DIFFICULT‟ THOUGHTS AND FEELINGS CAN

INTERFERE WITH OUR ACTIONS/
BEHAVIOURS/ GOALS
 Mindfulness Introduction

• Developing greater present moment

awareness

• Noticing the difference between:

• Being „lost‟ in thought, and

• Aware of thoughts coming and going

• Taking a non-judgemental view of all

thoughts, feelings, and sensations
 Linking mindfulness and values-
based action

Let’s look at why we will be practicing these

rather strange exercises – to start revealing the
purpose of this training:

1. Benefits of mindfulness

2. To ensure that our own thoughts and feelings do

not interfere with our chosen life directions and
goals
Passengers on the bus about
here!
 Passengers on the Bus

While fighting / arguing with/ trying to remove

the unwanted passengers seems the sensible
thing to do......

• Do the unwanted passengers get off and stay off

the bus?
• What‟s happening to the bus while we are back
there fighting/ arguing with the passengers?

• Does engaging with the passengers make them

more or less important in our lives?
 The Bus of Life Exercise

For one important area of your life:

1. Identify the most important chosen direction for your bus
service (values)

2. Identify a few bus stops along the way (goals)

3. Identify the very next turn (tonight/ tomorrow/ this

week) (actions)

4. Identify any passengers (thoughts, feelings, memories,

urges etc) that have the potential to „hijack‟ your bus
(internal barriers)
Theory bit

Inside the skin/ outside

the skin distinction
(Undermining experiential avoidance)
 More mindfulness/ acceptance work

What is the alternative to fighting/ arguing/

debating/ suppressing these passengers?

• „Untangling‟ from them

• Getting a bit of distance between you and your

passengers

• Seeing them for what they actually are

**Physicalizing exercise about here**

 Session 1 Homework

• Bring present moment awareness to your

journey to work each day

• Mindfulness of breathing (10 mins each day)

• Complete the Bus of Life exercise across five life areas

Start to get a good sense of:

1) Your chosen values, goals, actions

2) Any „difficult‟ or „unhelpful‟ passengers that want to control
your bus
 ACT Stance

Focused on the core processes from the outset...

Trainer: Does anyone else have any hopes or

expectations about what you might get from
these three sessions?
Participant: I‟d love to learn something that would help me to
stop worrying and going over and over things in
my head.

Trainer: Right. So your mind loves a good worry?

Participant: It sure does. You name it, I‟ll worry about it!
 ACT Stance

Trainer: Neat. We‟ll have a good look at that

in these sessions; worrying is one
thing minds are very good at! My mind is
the same – it loves a good old
worry. Anyone else‟s mind do something
similar?

(all but one person in the group raised their hands)

 ACT Stance

After a physicalizing exercise...

Trainer: Did anyone notice a feeling or

sensation pop up?

Participants: I certainly did. It was like a sense of

dread or foreboding.

Trainer: Great. Nice. And where in your body

did you experience that?
 ACT Stance

Participant: Right in the pit of my stomach – like a burning

sensation and a feeling of heaviness

Trainer: Good stuff - you've really

noticed it. And did it take on
some shape and form as if it were a
physical object... ?
 Session 2 (one week later)
Session aim: Strengthening the two core
skills

• Mindfulness of breathing/ body (5 to 10

mins)
• Mindfulness homework review (brief)

• Values homework review (additional coaching

around values, goals, and actions)
 Defusion

Did anyone find that their ‘Mind Chatter’

interfered with values-directed action?

Anything your Mind ‘says’ that causes you to

stop the bus or move in a less valued direction?

So, let’s look at a couple of exercises that help

to ensure YOU are the driver .........
 Defusion

I’m having the thought

“I‟ll do it tomorrow” that...“I‟ll do it tomorrow”

“Why should I, he doesn't I’m having the thought that

really deserve it” ...”he doesn't really deserve it”

I’m having the thought that

“I‟ll probably do it
...”I‟ll probably do it wrong”
wrong”
 Defusion

Also works with the ‘feeling’ passengers:

I’m having a feeling of....

It‟s embarrassing embarrassment

I was having a feeling of....

I was too stressed stress

I was having a bodily

sensation of.... a knot in my
throat and chest

A use of language that establishes some healthy

distance between you – a conscious human being –
and your internal experiences
 Defusion

Let’s take a look at these thought passengers

for what they actually are:

**Milk exercise here**

Quickly followed by other thought barriers that

came up “tomorrow”, “wrong”, “no time”, “danger”
etc

And we let this control our actions, and

therefore our life?!
 Defusion

Also useful to start glimpsing thoughts as

thoughts as they come and go

Noticing those moments when we get hooked by

a particular thought

***White Screen OR Leaves on the Stream

OR Soldiers in the Parade here***
 Self-as-context

There’s a highly resilient and stable part of you

being used and slowly revealed here
• From where were you observing your thoughts just now?

• Who was noticing your breathing?

The observing self:

• A perspective that we don't often use
• You find it every time you practise a mindfulness exercise
• A place that is unharmed by difficult thoughts and feelings
 Final values clarification, goal and
action planning

Step 1: Pick one of your most important values – see if you can capture it
in just a few words

Step 2: Identify short-term, medium term, and long-term behavioural

goals that would help you pursue that direction

Step 3: Choose the next action that will get you moving down that valued
path
 Taking a stand

Each person stands, states the value, along

with the next values-based action
 Session 2: Homework

• Consider the next few weeks as the testing

ground for cementing these two core skills

• Four week schedule of mindfulness practice

(supported by CD)

• Values-based goal and action planning sheets

Pursuing valued actions will surely give rise to

potential internal barriers for you to work on
 Session 3 (1, 2, or 3 months later)

• Cementing the two core skills

• Mindfulness practice and check-in

• Bull‟s eye exercise

• Additional defusion work on barriers

• Physicalizing exercise or Tin Can Monster

• Taking a stand on most important valued

direction for the rest of this year
ALL
ABOARD!

Thank you for listening!