Acceptance and Commitment Therapy & Mindfulness For Psychosis
Samenvatting
This is the first volume to present a broad picture of theory and application for clinical approaches incorporating ACT and mindfulness in working with psychosis. It provides an overview and introduction to the subject, including a review of the evidence base. Clinical and practical applications are supported with case studies in both individual and group work, with an emphasis on utilizing these strategies in a clinical context. Addressed to practitioners, this book is idea for clinical and counseling psychologists, CBT therapists, and psychiatrists.
Specificaties
Inhoudsopgave
<p>List of Contributors xvi</p>
<p>Acknowledgements xix</p>
<p>Foreword: Acceptance, Mindfulness and Psychotic Disorders: Creating a New Place to Begin xx</p>
<p>1 Introduction to Mindfulness and Acceptance–based Therapies for Psychosis 1<br /> Joseph E. Oliver, Candice Joseph, Majella Byrne, Louise C. Johns and Eric M. J. Morris</p>
<p>1.1 Introduction to Psychosis 1</p>
<p>1.2 Interventions 2</p>
<p>1.2.1 Cognitive Behavioural Therapy 2</p>
<p>1.2.2 Developments in CBT: Contextual Approaches 3</p>
<p>1.2.3 Acceptance and Commitment Therapy 4</p>
<p>1.2.4 Mindfulness and Person–based Cognitive Therapy for Psychosis 7</p>
<p>1.3 Conclusion 8</p>
<p>2 Theory on Voices 12<br /> Fran Shawyer, Neil Thomas, Eric M. J. Morris and John Farhall</p>
<p>2.1 Phenomenology 12</p>
<p>2.2 Mechanisms and Origins of Hearing Voices 13</p>
<p>2.3 Meaning Given to Voice Experience 14</p>
<p>2.4 Responses to Voices 15</p>
<p>2.4.1 Resistance 16</p>
<p>2.4.2 Engagement 17</p>
<p>2.5 Implications for the Role of Acceptance and Mindfulness in Voices 18</p>
<p>3 Emotional Processing and Metacognitive Awareness for Persecutory Delusions 33<br /> Claire Hepworth, Helen Startup and Daniel Freeman</p>
<p>3.1 Introduction 33</p>
<p>3.2 Persecutory Delusions 33</p>
<p>3.3 Improving Treatments for Persecutory Delusions 34</p>
<p>3.4 Development of the Intervention 35</p>
<p>3.5 The EPMA Intervention 38</p>
<p>3.6 The EPMA Pilot Study 40</p>
<p>3.7 Case Study 41</p>
<p>3.8 Conclusion 42</p>
<p>4 Clinical Assessment and Assessment Measures 47<br /> John Farhall, Fran Shawyer, Neil Thomas and Eric M. J. Morris</p>
<p>4.1 Introduction 47</p>
<p>4.2 Clinical Assessment 47</p>
<p>4.2.1 Overview 47</p>
<p>4.2.2 Structure and Methods of Assessment 49</p>
<p>4.2.3 A Guide to Clinical Assessment 51</p>
<p>4.2.4 Assessing and Addressing Potential Barriers to and Risks Arising from Therapy 52</p>
<p>4.3 Assessment Measures 54</p>
<p>4.3.1 Issues in the Use of Self–report Measures 55</p>
<p>4.3.2 Mindfulness Measures 55</p>
<p>4.3.3 Measures of ACT Processes and Constructs 57</p>
<p>4.4 Conclusion 60</p>
<p>5 Acceptance and Commitment Therapy Case Formulation 64<br /> Patty Bach</p>
<p>5.1 Introduction 64</p>
<p>5.2 Case Study 64</p>
<p>5.2.1 Avoidance 66</p>
<p>5.2.2 Cognitive Fusion 67</p>
<p>5.2.3 Attachment to Content 67</p>
<p>5.2.4 Weak Self–knowledge, Dominating Concept of the Past or Feared Future 68</p>
<p>5.2.5 Lack of Values Clarity 68</p>
<p>5.2.6 Persistent Inaction, Impulsivity or Avoidance 69</p>
<p>5.3 Case Formulation using the Inflexahex Model 70</p>
<p>5.4 Conclusion 73</p>
<p>6 Engaging People with Psychosis in Acceptance and Commitment Therapy and Mindfulness 76<br /> Brandon A. Gaudiano and Andrew M. Busch</p>
<p>6.1 Introduction 76</p>
<p>6.1.1 Treatment Adherence and Engagement in Psychosis 76</p>
<p>6.2 Acceptance and Commitment Therapy 77</p>
<p>6.3 Functional Analytic Psychotherapy 78</p>
<p>6.4 Acceptance–based Methods and Techniques for Improving Engagement 79</p>
<p>6.4.1 Workability 81</p>
<p>6.4.2 Values Clarification 81</p>
<p>6.4.3 Acceptance and Mindfulness 82</p>
<p>6.4.4 Committed Action 83</p>
<p>6.4.5 The Therapeutic Relationship 84</p>
<p>6.5 Special Contexts and Issues 85</p>
<p>6.5.1 ACT Made Even Simpler 85</p>
<p>6.5.2 Involuntary Admission and Lack of Insight 86</p>
<p>6.5.3 Other Cognitive Behavioural Approaches for Psychosis 86</p>
<p>6.6 Case Study 88</p>
<p>6.6.1 Early Sessions (1 5) 88</p>
<p>6.6.2 Mid–treatment Sessions (6 15) 89</p>
<p>6.6.3 Late–treatment Sessions (16 20) 89</p>
<p>6.7 Conclusion 90</p>
<p>7 Acceptance and Commitment Therapy for Voices 95<br /> Neil Thomas, Eric M. J. Morris, Fran Shawyer and John Farhall</p>
<p>7.1 Introduction 95</p>
<p>7.2 Formulating how Voices are a Problem 95</p>
<p>7.3 Overall Considerations in Conducting ACT with Voices 96</p>
<p>7.3.1 Sequence of Therapy 98</p>
<p>7.3.2 Acceptance: Letting Go of Struggle with Voices 98</p>
<p>7.3.3 Defusion 100</p>
<p>7.3.4 Mindfulness: Present Moment and Self as Observer 101</p>
<p>7.3.5 Willingness: Values and Committed Action 103</p>
<p>7.4 Case Study 104</p>
<p>7.4.1 Current Mental–health Problems 104</p>
<p>7.4.2 Mental–health History 105</p>
<p>7.4.3 Relevant Background 105</p>
<p>7.4.4 Assessment and Formulation 105</p>
<p>7.4.5 ACT Case Formulation 106</p>
<p>7.4.6 The ACT Approach 106</p>
<p>7.4.7 Outcomes 108</p>
<p>7.4.8 Discussion 110</p>
<p>8 Acceptance and Commitment Therapy for Delusions 112<br /> José Manuel García Montes, Marino Pérez Álvarez and Salvador Perona Garcelán</p>
<p>8.1 Introduction 112</p>
<p>8.2 Delusions as Ways of Making Contact with Experience 112</p>
<p>8.2.1 Delusions as Active Forms of Experiential Avoidance 113</p>
<p>8.3 Intervention with ACT 115</p>
<p>8.3.1 Create a State of Creative Hopelessness 115</p>
<p>8.3.2 Clarify and Strengthen the Patient s Values 117</p>
<p>8.3.3 Suggest the Possibility that the Problem is Control 120</p>
<p>8.3.4 Create a Distance from Language 122</p>
<p>8.3.5 Help Create a Transcendental Sense of Self 123</p>
<p>8.3.6 Developing Willingness 124</p>
<p>8.4 Conclusion 125</p>
<p>9 Acceptance and Commitment Therapy for Emotional Dysfunction following Psychosis 129<br /> Ross White</p>
<p>9.1 Introduction 129</p>
<p>9.2 Understanding Emotional Dysfunction following Psychosis 129</p>
<p>9.3 Emotional Dysfunction and Experiential Avoidance 130</p>
<p>9.4 An ACT Conceptualisation of Emotional Dysfunction following Psychosis 131</p>
<p>9.5 Treating Emotional Dysfunction following Psychosis 132</p>
<p>9.5.1 Socialising the Individual to the ACT Model 133</p>
<p>9.5.2 Assessment and Formulation 133</p>
<p>9.5.3 Beyond Formulation: Progressing with the ACT Intervention 138</p>
<p>9.5.4 Moving Beyond the ACT Intervention 141</p>
<p>9.6 Conclusion 142</p>
<p>10 Person–based Cognitive Therapy for Distressing Psychosis 146<br /> Lyn Ellett</p>
<p>10.1 Introduction 146</p>
<p>10.2 Zone of Proximal Development 146</p>
<p>10.2.1 Overview of the Zones of Proximal Development 147</p>
<p>10.3 Case Formulation in PBCT 150</p>
<p>10.3.1 Symptomatic Meaning: ABC Formulation 150</p>
<p>10.3.2 Relationship with Internal Experience: Mindfulness–based Formulation of Distress 151</p>
<p>10.3.3 Negative and Positive Self–schema 152</p>
<p>10.4 Experiential Methods of Change 153</p>
<p>10.4.1 Symptomatic Meaning 153</p>
<p>10.4.2 Relationship with Internal Experience 156</p>
<p>10.4.3 Working with Schemata 157</p>
<p>10.4.4 Symbolic Self 158</p>
<p>10.5 Conclusion 159</p>
<p>11 Spirituality: A New Way into Understanding Psychosis 160<br /> Isabel Clarke</p>
<p>11.1 Introduction 160</p>
<p>11.2 Repositioning Psychosis and Spirituality: Recognition of the Two Ways of Knowing 161</p>
<p>11.3 Research Basis 162</p>
<p>11.4 Spirituality and Mental Health 162</p>
<p>11.5 Clinical Approach: The Therapeutic Alliance 164</p>
<p>11.5.1 The What is Real and What is Not Approach 164</p>
<p>11.5.2 Schizotypy and Unshared Reality 165</p>
<p>11.5.3 From Conceptualisation to Coping Strategies 166</p>
<p>11.5.4 Role of Mindfulness 167</p>
<p>11.6 Psychosis as a Spiritual Crisis 168</p>
<p>12 The Service User Experience of Acceptance and Commitment Therapy and Person–based Cognitive Therapy 172<br /> Joseph E. Oliver, Mark Hayward, Helena B. McGuiness and Clara Strauss</p>
<p>12.1 Introduction 172</p>
<p>12.2 An Overview of Service User Involvement 172</p>
<p>12.3 The Importance of a Service User Perspective in Informing ACT and PBCT for Psychosis 174</p>
<p>12.4 A Service User Perspective on the Experience of ACT for Psychosis 175</p>
<p>12.4.1 Background 176</p>
<p>12.4.2 The Therapy 178</p>
<p>12.4.3 How the Therapy Helped 178</p>
<p>12.4.4 Conclusion 179</p>
<p>12.5 Summary of Qualitative Findings from PBCT Groups on Participant Experiences of Mindfulness Practice and What was Learned from these Studies 180</p>
<p>12.5.1 Acceptance of Voices 181</p>
<p>12.5.2 Development of Sense of Self beyond Voices 182</p>
<p>12.5.3 The Value and Challenges of Seeking Service User Views 188</p>
<p>12.6 Conclusion 188</p>
<p>13 Acceptance and Commitment Therapy for First–episode Psychosis 190<br /> Joseph E. Oliver and Eric M. J. Morris</p>
<p>13.1 Introduction 190</p>
<p>13.2 Recovery from a First Episode of Psychosis 191</p>
<p>13.2.1 At–risk Mental States 192</p>
<p>13.3 Using ACT to Enhance Recovery from a First Episode of Psychosis 192</p>
<p>13.3.1 Assessment and Formulation 192</p>
<p>13.3.2 Being Aware and Present 194</p>
<p>13.3.3 Opening Up 195</p>
<p>13.3.4 Being Active 197</p>
<p>13.4 ACT in Different Modalities 198</p>
<p>13.4.1 Group Work 198</p>
<p>13.4.2 Working with Families and Carers 199</p>
<p>13.5 Case Study 200</p>
<p>13.6 Conclusion 203</p>
<p>14 Acceptance and Commitment Therapy for Psychosis in Acute Psychiatric Admission Settings 206<br /> Gordon Mitchell and Amy McArthur</p>
<p>14.1 Introduction 206</p>
<p>14.2 Acute Psychosis and ACT Interventions 206</p>
<p>14.3 ACT in the Acute Psychiatric Admission Ward 209</p>
<p>14.4 Case Study 209</p>
<p>14.5 Convergence of Mindfulness/Metacognitive–based Cognitive Therapy Approaches 214</p>
<p>14.6 Reflections on Developing Systemic Applications of ACT 215</p>
<p>14.7 Conclusion 216</p>
<p>15 Developing Acceptance and Commitment Therapy for Psychosis as a Group–based Intervention 219<br /> Amy McArthur, Gordon Mitchell and Louise C. Johns</p>
<p>15.1 Introduction 219</p>
<p>15.2 A Six–session ACT–for–Psychosis Group Protocol 221</p>
<p>15.2.1 Session 1: Introducing the ACT Approach and Exploring the Workability of Current Strategies for Managing Distress 222</p>
<p>15.2.2 Session 2: Exploring the Impact of the Struggle for Control and Introducing Willingness as an Alternative 223</p>
<p>15.2.3 Session 3: Identifying Personal Valued Directions 225</p>
<p>15.2.4 Session 4: Moving in Valued Directions 227</p>
<p>15.2.5 Session 5: Continuing to Develop Self–as–Context and Willingness to Move towards Values 229</p>
<p>15.2.6 Session 6: Summarising the Themes of the Course and Reviewing Experiences of the Work 230</p>
<p>15.2.7 Optional Follow–up Session 230</p>
<p>15.3 Case Study 231</p>
<p>15.4 Reflections on the Experience of Developing and Delivering the Groups 233</p>
<p>15.5 Other Protocols 234</p>
<p>15.5.1 ACT for Life Group 235</p>
<p>15.6 Conclusion 237</p>
<p>16 Group Person–based Cognitive Therapy for Distressing Psychosis 240<br /> Clara Strauss and Mark Hayward</p>
<p>16.1 Introduction 240</p>
<p>16.2 Person–based Cognitive Therapy 240</p>
<p>16.2.1 Group PBCT 242</p>
<p>16.3 The Importance of the Group Process in PBCT 242</p>
<p>16.4 Facilitating a PBCT Group 243</p>
<p>16.4.1 Inclusion Criteria 243</p>
<p>16.4.2 The 12–week Programme 243</p>
<p>16.4.3 Mindfulness Practice in PBCT 244</p>
<p>16.4.4 Cognitive Therapy in PBCT 247</p>
<p>16.5 PBCT: An Integrated Model 252</p>
<p>16.6 Group PBCT: The Evidence 253</p>
<p>16.7 Conclusion 254</p>
<p>Appendix A Chessboard Metaphor 256</p>
<p>Appendix B Leaves–on–the–Stream Metaphor 257</p>
<p>Appendix C Passengers–on–the–Bus Metaphor 259</p>
<p>Appendix D Person–in–the–Hole Metaphor 261</p>
<p>Appendix E Polygraph Metaphor 262</p>
<p>Appendix F See the Wood for the Trees (And Other Helpful Advice for Living Life) 263</p>
<p>Appendix G Skiing Metaphor 270</p>
<p>Appendix H Tug–of–War–with–the–Monster Metaphor 271</p>
<p>Index 272</p>

