#OTalk 8th December 2020 – Is there a role for Acceptance and Commitment Therapy (ACT) in occupational therapy practice?

This weeks chat will be hosted by Abigail Matthews @Abi21643842

I have recently started to learn about the role of Acceptance and Commitment Therapy (ACT) in supporting individuals with severe and enduring mental health needs, through an occupational lens. This therapy teaches that people should focus on what they can control and make actions towards values which create a meaningful life. ACT is a mindfulness-based behavioural therapy that encourages clients to expand their lives alongside the existence of inevitable pain and suffering (Harris, 2011). His renowned self-help book the happiness trap (2011, b) prioritises acceptance and personal development over symptom reduction. If one is focused on improving the present moment, there is recognition of the world of opportunities outside our own self-critical thoughts and current difficulties. We are more than the sum of our past experiences, thoughts and feelings (Harris, 2011). The 21st century is full of complexity and life stressors (eg. work, politics and healthcare) which can ultimately negatively impact mental health and well-being, if we do not embrace contentment and meaning in everyday life (Harris, 2011).  If we solely focus on solving problems we will never achieve happiness. In a similar way, Behavioural activation helps alleviate depression through planning pleasurable activities based on what we are motivated to change (Ekers et al, 2014). It teaches us that we are able to control our mood through our behaviour. This approach is often used by Occupational therapists to create change based on the occupations that we both want and need to do in order to live a fulfilling life. To maintain health and well-being, Occupational Therapy helps people to develop a sense of being, becoming and belonging through engagement in everyday life (Wilcock, 1998). In a similar way to ACT, solution focused brief therapy also focuses on achieving happiness by exploring solutions rather than trying to resolve indicators of poor health (Nicholas and Schwartz, 1998). These psychological approaches appear to hold a common focus in identifying action aligned with personal values. It could be argued that as Occupational Therapist we are already following a values based approach, given that client centred prioritises what’s important to the client (Townsend et al, 1990). It is through expanding our occupations of interest (self-care, leisure and productivity) that we can maintain our mental health and well-being (CAOT, 2002). This OTalk will explore these psychological approaches further and consider their place in OT practice.

Questions

What do you feel is the role of ACT in your setting and working with specific population needs?

What OT tools and strategies could you use to embed an ACT perspective in your practice?

How well do you as occupational therapist embrace a values based approach in your practice?

What have you taken from today that will support you in your OT role?

References

Canadian Association of Occupational Therapists (CAOT, 2002). Enabling occupation: an occupational therapy perspective. Ottawa, ON: Canadian Association of Occupational Therapists.

Harris, R. (2011a). Embracing your demons: An overview of Acceptance and Commitment Therapy. Psychotherapy. Retrieved from https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT#section-the-goal-of-act

Harris, R., (2011b). The happiness trap. ReadHowYouWant. com.

Nichols, M. and Schwartz, R., 1998. From strategic to solution focused: The evolution of brief therapy. M. Nichols & R. Schwartz, Family therapy: Concepts and methods, pp.355-396.

Townsend, E., Brintnell, S., Staisey, N. (1990). Developing guidelines for client-centred occupational therapy practice. Canadian Journal of Occupational Therapy, 57, 69–76.

Wilcock, A. (1998). An occupational perspective of health. Thorofare, NJ: Slack.

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