JoAnne Dahl
University of Uppsala, Sweden
Jennifer Plumb
University of Nevada Reno, USA
A workshop presented June 22, 2010
at ACBS World Conference VIII, Reno, NV
 What

is difficult about doing values work?
What does “values work” mean to you?
 Values
can:
 Help clients define what matters to them
 Create a sense of meaning and purpose
 Provide a framework for setting specific
goals
 Provide a context in which contacting
uncomfortable experiences is worthwhile
 Help clients practice direct experience of
valued activity, sustaining desired behavior
patterns
 1.
Unwanted experiences
 2.
A narrowed life

LACK OF VALUES CONSISTENT BEHAVIOR
 What
are some ways in which your clients
have narrowed their lives?
 Symptoms


Take too much time
Thoughts dictate impossibility of valued living in
some way
 Avoidance

Of discomfort that comes from doing certain
things – very often things that matter
 Early
on, discriminating in the body – vitality
and not (Exercise)
 Moving
from symptom reduction to creating a
life worth living
 Validate the client’s experience in wanting
to reduce the ‘problem’
 Think
about what you care about most…
 At any moment in time, have you really
achieved it?
 Most
things we care about involve temporally
distant consequences
 We can value things we never directly
experience

World Peace, Healthy Environment
 The
upside of language abilities!

Transformation of functions
Process by which language can control our behavior
 A good thing, in certain contexts


Rule-governed behavior
Values are a form of self-directed rules
 In non-technical language, freely chosen
 Pliance



Beh under control of reinforcement from social
community for rule-following
Tracking


Beh under control of coordination of the rule and the
natural consequences in environment
“Wear a coat, it’s cold!”
 I wear it because I have kept warm in the cold by
wearing coat in the past.
 Therapeutic
 Chronic

Role Play
pain patient
Life Compass: 0 on intimate relations/friends
 The





quick and dirty model of valuing
Identify a Valued Direction
Look at Function
Choose Goals in Service of Values
Evaluate Choices
Establish a Pattern
 In
your pain you find your values, in your
values you find your pain
 Group
Activity:
 Turning Over Suffering: What Matters?
 Which
Master do You Serve?
 Appetitive vs. aversive

Living in Service of Experiential Avoidance





Striving for Secondary Reinforcers


Show me the MONEY!
Keeping Up Appearances


Valuing can be scary!!
Uncertainty
Fear of certain outcomes
When we care, ‘real’ risks occur
Looking good, feeling empty
In RFT: Pliance or avoidance versus tracking

An exercise to use throughout therapy

Applied example available in Values book
1. Identify valued direction – suggestion, use
self-compassion first
 2. Examples when turned away from selfcompassion (painful events in life)
 3. What rule was learned?
 4. Ask client to experientially identify when on
line towards self-compassion and when turned
away from self in experiential avoidance, etc.
 5. Practice moving toward self-compassion even
when get pulled into circles off the line

 Marriage
of mindfulness and values
 Anything
can become aversive

Practicing attending to values in activity
 Landing


in the positive reinforcement
Paying attention – what matters to you here?
Can you approach the situation from that place
rather than a “Have To” place?
I
miss Mom.
 I call Mom.
 She’s mad I haven’t called in a few weeks.
 I feel bad.
 AND I lived my values.
 Will I do it again?



Where’s the reinforcer???
= Values-Consistent Reinforcement
Because sometimes the environment doesn’t
support valuing!!
Relationships
Values
loving, open, caring towards myself
Treating everyone I meet with respect and kindness
caring , open and honest with my family
caring and open with friends
seeing, listening and showing respect to those I work with
Goals
Health
Values
Listening to what my body needs and taking best possible care, no
matter what condition
Eating nutrias foods, exercising regularly, sleeping properly
taking walks every day
go to yoga classes
play tennis once a week
Goals
Work
Values
Being useful, contributing in any context
Remembering why I wanted to become a teacher
being present in my job
Being a caring teacher
Goals
Own Time
Values
Creating a space for me to be alone with myself
Getting into contact with my own voice
Being willing to sit with my restlessness, loneliness
Painting, dancing, writing, meditating
Goals

Life Line

Values Compass*

Trying On a Value

Bulls Eye

Valued Action Plans

Looking for Value Inside Aversives
 Trying


Use when impoverished history with valuing, need to
build commitment patterns, highly fused
(right/wrong)
Considerations: Seems arbitrary, requires some
present moment skills to track reinforcement and
attention to commitment
 Values


on a Value (handout)
Compass
Use throughout therapy, attends to many valued
domains, encourages attention to function
Considerations: Can be overwhelming for clients to
do all at once, or if clients have difficulty clarifying
values -- use in small doses over sessions, pick one
domain
Relationships
pliance, satisfying others at my own cost
present, loving
with myself
0...........10
10.....................0
10...........0
Taking care of my
physical needs
Disregarding my needs
Health
Relationships
pliance, satisfying others at my own cost
present, loving
with myself
0...........10
Balance
10.....................0
Taking care of my
physical needs
10...........0
Disregarding my needs
Health

Bulls Eye (handout)




Simple (uses common life domains), has many uses
Each session, weekly process measure, ‘outcome’
measure
Easily see progress
Valued Action Plans
Best if establish short, middle, and long-term goals
 Use of “team”: Brings in social
reinforcement/accountability
 Attends to incremental behaviors
 Considerations: Be specific, identify internal and
external barriers (and internal barriers inside external
barriers)


Looking for the Value in Aversives

Unpacking anger and judgment



Looking at ‘unpleasant’ activity – reconnecting to
vitality



What value may have been transgressed?
Can you let go of judgment and move toward the value?
So much of what we do doesn’t ‘feel good’ in the
moment
Is there vitality inside why you do this?
Caution: Not about reframing (for it’s own sake),
cheerleading, or asserting that we should seek to feel
vital in all things
 Your
clinical examples…

Early in Therapy

Mid-Therapy

Later in Therapy

In the Therapeutic Relationship itself

File Drawer (see Values DVD in ACT in Action Series)

Turning Over Suffering: What Matters?

Unpacking Anger & Judgment

Postures - Non-verbal way of getting values into therapy
Can you recall a time when you felt completely alive, nothing
was missing? Show me a posture that demonstrates this.
 How about a time when you felt like your mind was trying to
protect you from getting hurt? What is that posture?
 Can we make treatment about having more moments like A
versus B?


All can be clinical tools, exercises for yourself, used in
supervision
 Not
about ‘right’ or ‘wrong’
 Is doing X, Y or Z the most effective way to
live the life you want?


Self-injury
Compulsive behavior
 If
not, what could you do differently to move
toward your values?
 What shows up in committing to doing that?

Opportunity for mindfulness (acceptance,
defusion, etc.)
 Flexibility
to persist or change
 What
do I care about most in my life?
 What is difficult about living consistent with
these values?
 How do my values show up inside what I do
in my larger life, and in therapy?
 How can I model valuing in the room?
 Handout:
Parallel Process Questions

Discrimination training


Building attention to positive reinforcers


Process vs. outcome
Present moment awareness
Transformation of function
Reinforcement comes from values-consistent living
 Vitality inside aversives?


Willingness = All or Nothing

Fully engage (acceptance for imperfection likely to
arise), regardless of outcome
 Slides
will be posted online
 Contact
us anytime:
 joanne.dahl@psyk.uu.se
 jcplumb@gmail.com