It’s 9.45am on an early autumn Sunday morning, in an otherwise-empty teaching block at the University of Birmingham, on a campus where all the students are asleep, hung-over or – in fact – still partying. In a large teaching room, 23 experienced ACT practitioners are already deep into their own persistent, yet unhelpful self-stories, and are exploring how these can get in the way of being the therapists they want to be. The first tears of the day are showing up, with another six hours of advanced theory, practice, close observation and feedback on skills still to come. It’s going to be emotional…
..Welcome to ‘ACT Like a Pro’!
This is an account of a two-day advanced ACT skills workshop that we ran in September 2017 as part of the yearly . We suspect that some of what we did, and how we did it, is relatively uncommon, so we thought it would be worthwhile to describe both content and process for anyone else wanting to carry out a similar advanced training format. We’re very happy to share materials if you get in touch.
One of the facilitators, Rich Bennett, had set up ‘Birmingham ACT Week’, a ‘boot camp’ style training event at the University of Birmingham 4 years previously, and now organises it annually. The rest of us had taught on the programme every year since its inception. Birmingham ACT week provides a 2-day Introductory / Experiential course, a one-day practical basics workshop, and a two-day Intermediate workshop on consecutive days. In the past, there had been individual, specialist days the following week (e.g. ACT for… Sleep, Psychosis, Health, Grief).
There’s a lot of good ACT training around in the UK these days. One thing we’d noticed, though, was that was relatively little aimed at the established ACT practitioner who has already done various intermediate and specialist events, and who wants to develop their skills further. Thus was born the idea of an advanced 2-day skills-based course. The title ‘ACT like a Pro’ was borrowed following a conversation between Rich and his supervisor, Rikke Kjelgaard, who runs similar events in Scandinavia (“It’s a f***ing awesome title”: Kjelgaard, 2017)
A WhatsApp group chat, occasional Skype meetings, and a planning session held in a Seville park during the ACBS WorldCon eventually led to the course we delivered.
The course ran over 2 days with a total of 19 participants. Each day started and ended with an hour long plenary session for the whole group. Each plenary had the same structure, beginning with an experiential exercise, followed by open discussion and reflections on the workshop sessions.
The participants were divided into 4 small groups, who during the two days rotated through four specific ‘workshop’ sessions of about 2 hours length. Each workshop was run on four occasions by one of the facilitators.
Each separate workshop included provision of new learning and in-depth skills practice, based on the Portland Supervision Model . By rotating roles through the workshops, each participant had at least one opportunity to practice their skills, to present a relevant issue (either their own or roleplaying a client), to be advisor to the person practising their skills, or tracking the key ACT skills being demonstrated. Deviating from the usual model, the workshop facilitator also provided direct feedback and suggestions where useful.
The four plenary sessions, in which the whole group came together, were used to cover a range of issues, including logistics of the course, group exercises, and reviews of learning.
They aimed to set a context that might help facilitate the learning that participants gained from the workshop. We also worked on building the ‘stance’ of the course (see below) by video and small group discussion tasks emphasising openness, vulnerability, and compassion, and reflection upon our own self-stories as therapists.
Here are the descriptions of the four 2-hour workshop sessions (that each small group rotated through) as described in the course programme
FAP-ing up The Matrix – Rich Bennett
It is a widely-held assumption in psychotherapy that both clients and therapists bring their typical patterns of interpersonal interaction with them into the therapy room. This session will focus on the use of the ACT Matrix to shape in-session behaviours of clients, in the service of strengthening the impact of interpersonal relationships, both inside and outside of the therapeutic relationship. It will draw on the general principle of the use of the ACT Matrix, as well as principles from Functional Analytic Psychotherapy (FAP).
The aim of the session is to help participants focus on discriminating in-session between helpful and unhelpful interpersonal behaviours, bringing attention to these through the mechanism of functional analysis.
Expanding the Power of Present-Moment Focus – Jim Lucas
Just as your clients struggle, it is easy for you to get lost in the hexaflex wondering, “Where do I go next?” or “Have I done enough work on that process?” You too can get caught up trying to fix, problem-solve, or talk about what to do instead of doing it. When this happens, you are moving away from experientially-focused learning. In this session, you will be using and re-using the present-moment to enhance psychological flexibility. Drawing on the work of Strosahl & Robinson (2015), you’ll get to develop your ACT skills by applying five distinct phases of intervention. Specifically, to observe, describe, let-be, soften, and expand. These five sets of skills help you stay on track when attempting to reduce experiential avoidance and rule-governed behaviours.
The Self and Perspective Taking – using RFT to Supercharge Self Acceptance – Joe Oliver
Understanding the “self” is like the holy grail of psychology. And yet, self-as-context is the part of the ACT model practitioners most often shy away from. However, with a good understanding of “selfing” issues, we can help us unlock any number of thorny, stuck issues that come up in working with clients. The aim of this session is to equip practitioners with simple, practical skills for understanding and using self-as-context processes. The focus will be on how to move towards self-acceptance through the elegant use of ACT and RFT principles, most notably deictic relations.
How We Get In Our Own Way – Ray Owen
ACT and other contextual behavioural approaches emphasise that the therapist is subject to the same processes as the client, and consequently the same potential sources of inflexibility. When these inevitably show up for the therapist during sessions, they may push her/his behaviour in less workable directions.
This session will invite participants to consider their own recurring sources of inflexible responding in the context of clinical sessions, and focus upon developing greater awareness of their occurrence, openness in responding to them, and engagement in moving towards valued outcomes in therapy, even in their presence.
From the earliest stages of planning, all four of us were keen to not only pay attention to the content and the mechanisms of teaching, but also to embody a shared, values-based approach.
In particular, we sought to model
- openness and vulnerability, both in the group exercises and in the disclosures and interactions of the facilitators. The sense of “all in it together” was further reinforced by an open invitation to the pub and meal together on the first evening
- respect for the skills and experience brought into the room by the participants in this ‘advanced’ workshop. For example, during introductions a tally of “years of experience in healthcare” was taken, demonstrating that there was over 350 years of experience in the room. This experience was to be used, reflected on and enhanced, rather than ignored or dismissed
- respect and feedback in all directions by the use of “Tootles” (brief, hand-written messages of appreciation that could be given directly to any other participant or facilitator to thank them for something they contributed – sometimes used in ProSocial work)
- ensuring that the learning in each phase addressed ‘head, heart & hands’ – i.e. comprehension/coherence, direct experience and noticing of our own thoughts and feelings, and practical skill development
The most important question for any enterprise like this is surely, “Did it help?” We can’t definitively know the answer, but here are our reasons for thinking that maybe it did.
The on-the-day ratings were overwhelmingly positive: participants were asked to rate the event on a 0-5 scale in terms of the quality of the new information provided (head), the experiential exercises (heart), and the skills practice (hands). The results were:
|Providing new information
Verbal feedback was also very positive, and participants were able to cite specific commitments to what they would do more of, or less of, in order to become more of the therapist they wanted to be. This event was not set up as a piece of research and had no formal measurement of behavioural change or follow-up. However, each of us facilitators has heard from multiple participants saying they continue to benefit from that intense but overall very useful weekend.
As four experienced trainers, we all felt that this was something different to our usual training events: not just in terms of the technical ‘level’ of the content, but in terms of the way that awareness, openness, and engagement were manifest throughout. ACT and other CBS practitioners will (hopefully) tend to bring that to an event, and the way the workshop was set up (the format, the stance, the modelling) further enhanced this.
In terms of hard economics, this is a difficult format to break even on – four facilitators, accommodation with space for four ‘breakout’ groups, catering etc, with only around 20 paying participants. This was only really viable as part of the broader activities of Birmingham ACT Week, some of which involved much larger numbers which could effectively cross-subsidise. However, we suspect that – as focussed as we could be with only 5 participants per workshop session – with a slight change to the groupwork setup, participant numbers could be doubled without losing the essential qualities of the skills work, which begins to make this format more financially viable.
One interesting barrier to participation was the reluctance some voiced to identifying themselves as ‘competent’ enough to take part in an ‘Advanced’ skills workshop – there were a lot of nervous emails prior to booking checking out whether they ‘deserved’ to be there. It may be that some potential participants were lost to their own self-doubt. We wondered if the name ACT Like a Pro added to this effect, but felt it was not the title per se but the concept of advanced workshops that evoked ‘imposter syndrome’. And yet, several participants also mentioned how nice it was to be in a setting where the core concepts of ACT were familiar to all and didn’t need explaining.
Finally, for myself, delivering the workshop was fun, challenging, affirming, and a bonding experience with fellow practitioners, including my good friends and colleagues Joe, Jim, and Rich. I want to especially thank Rich for initiating and organising the whole event, and his son who nobly gave up his bed for me, so that I could stay over for the weekend under his Star Wars duvet!
Ray Owen (email@example.com)
Rich Bennett (firstname.lastname@example.org)
Jim Lucas (email@example.com)
Joe Oliver (firstname.lastname@example.org)