Table Of ContentA
A
CBT Practitioner’s
Guide to C
T
How to Bridge the Gap Between
Cognitive Behavioral Therapy &
Acceptance & Commitment Therapy
JOSEPH V. CIARROCHI, PH.D.
ANN BAILEY, MA
FOREWORD BY STEVEN C. HAYES, PH.D.
New Harbinger Publications, Inc.
Publisher’s Note
Tis publication is designed to provide accurate and authoritative information in regard to the subject matter
covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, fnancial,
legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional
should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2008 by J oseph Ciarrochi and Ann Bailey
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup
Illustrated by Helen Bailey and Dave Mercer
Acquired by Catharine Sutker
Edited by Jean Blomquist
Text design by Tracy Carlson
All rights reserved
PDF ISBN: 9781572248731
Te Library of Congress has Cataloged the Print Edition as:
Ciarrochi, Joseph.
A CBT-practitioner’s guide to ACT : how to bridge the gap between cognitive behavioral therapy and
acceptance and commitment therapy / Joseph V. Ciarrochi, and Ann Bailey.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-1-57224-551-8 (pbk. : alk. paper)
ISBN-10: 1-57224-551-4 (pbk. : alk. paper) 1. Acceptance and commitment therapy. 2. Cognitive
therapy. I. Bailey, Ann, MA. II. Title.
[DNLM: 1. Behavior Terapy--methods. 2. Cognitive Terapy--methods. 3. Self Concept. WM 425
C566c 2008]
RC489.A32.C53 2008
616.89’142--dc22
2008029815
We dedicate this book to our daughter, Grace.
Contents
A Letter from the Series Editors vii
The First CBT Travel Guide to ACT ix
Acknowledgments xi
PART 1
Overcoming Cognitive Barriers to Valued Living
CHAPTER 1
Toward an Integration of ACT and CBT 3
CHAPTER 2
Escaping the Traps of Language 15
CHAPTER 3
Supercharging Traditional CBT Techniques 43
CHAPTER 4
Letting Go of the Self to Discover the Self 73
A CBT Practitioner’s Guide to ACT
PART 2
Moving Toward Acceptance and Action
CHAPTER 5
How Philosophical Assumptions Shape Our Lives 85
CHAPTER 6
The Possibility of Radical Acceptance 97
CHAPTER 7
Values and Commitment 117
CHAPTER 8
Promoting Emotional Intelligence 153
Afterword 167
APPENDIX A
Therapist Self-Exploration Workbook 169
APPENDIX B
The Behavioral Foundations of ACT and CBT 183
References 187
Index 19
vi
Dear reader,
Welcome to New Harbinger Publications. New Harbinger is dedicated to publishing books
based on acceptance and commitment therapy (ACT) and its application to specifc areas. New
Harbinger has a long-standing reputation as a publisher of quality, well-researched books for
general and professional audiences.
ACT is a third-generation behavior therapy. It is also an approach that, on the surface, has
a look and feel that may seem somewhat foreign to you if you are well versed in the practice of
cognitive behavioral therapy (CBT). And, you may wonder whether or how you might be able
to integrate ACT into your clinical practice. You might even wonder if it is possible to integrate
ACT with CBT in a way that upholds your values and commitments, and in a way that helps
you to better serve your clients. Te book you have in your hands aims to help you do just that.
Te authors of A CBT Practitioner’s Guide to ACT are clinicians with extensive experience and
expertise using traditional CBT and ACT. Tey know and draw upon both approaches regularly
in their clinical work, and have found a way to do that efectively. Tey wrote this book to share a
bit of what they have learned in the process so that you too might expand your clinical repertoire
in working with those people who seek you out because they are sufering.
Tis is not a book about ACT or CBT as just a set of techniques. Rather, it is about fnding a
way to be maximally efective using CBT and ACT as a coherent and principle-driven approach,
with attention to processes that may be important targets of intervention with a broad range of
clients. Te book itself is flled with a rich set of ideas and practical worksheets for you as a prac-
titioner and for your clients that will help you to do the following:
identify the therapeutic processes you put into play in therapy
recognize the processes you potentially overemphasize and the ones you underem-
phasize in therapy
greatly expand the repertoire of techniques you can utilize in therapy, in a way that
is theoretically coherent
expand your ability to create new exercises and metaphors for therapeutic practice
gain know-how that may be helpful to you when existing strategies do not appear
to be working
Te authors go to great lengths to provide you with something that may be immediately
useful in your clinical work. In fact, this beautifully paced book will gradually introduce you to
techniques and theory in a way that allows you to try some of these techniques in therapy without
necessarily giving up everything else that you normally do.
Tere are many ways to learn about CBT, ACT, and other approaches and how to apply them
in your clinical practice. You can attend a workshop or two. You might read several excellent
A CBT Practitioner’s Guide to ACT
books, join a reading or online discussion group, or perhaps follow the growing research literature.
You may even take a class on the topic, watch training DVDs, or practice applying CBT or ACT
under the guidance of an experienced supervisor.
Yet, even with all of that, you may still feel unsure about what to look for at the process level
and how to link those processes with therapeutic actions that are CBT and ACT consistent, fex-
ible, genuine, and helpful. Te authors of A CBT Practitioner’s Guide to ACT will help you fll in
those gaps and round out your professional development as a more efective and skillful behavior
therapist. Tis exceptionally well-crafted book is not the way to do ACT or CBT, but it will show
you one of many ways to do ACT alone or integrated with traditional CBT practices.
As part of New Harbinger’s commitment to publishing sound, scientifc, clinically based
research, Steve Hayes, Georg Eifert, and I oversee all prospective ACT books for the Acceptance
and Commitment Terapy Series. As ACT Series editors, we review all ACT books published by
New Harbinger, comment on proposals and ofer guidance as needed, and use a gentle hand in
making suggestions regarding the content, depth, and scope of each book. We strive to ensure
that any unsubstantiated claim or claims that are clearly ACT inconsistent are fagged for the
authors so they can revise these sections to ensure that the work meets the criteria below and
that all of the material presented is true to the roots of ACT (not passing of other models and
methods as ACT).
Books in the Acceptance and Commitment Terapy Series:
have an adequate database, appropriate to the strength of the claims being made
are theoretically coherent—they will ft with the ACT model and underlying behav-
ioral principles as they have evolved at the time of writing
orient the reader toward unresolved empirical issues
do not overlap needlessly with existing volumes
avoid jargon and unnecessary entanglement with proprietary methods, leaving ACT
work open and available
keep the focus always on what is good for the reader
support the further development of the feld
provide information in a way that is of practical use to readers
Tese guidelines refect the values of the broader ACT community. You’ll see all of them
packed into this book. Tey are meant to ensure that professionals and the general public get
information that can truly be helpful and that can further our ability to alleviate human sufer-
ing by inviting creative practitioners into the process of developing, applying, and refning this
approach to meet the needs of the human condition. Consider this book such an invitation.
Sincerely,
John Forsyth, Ph.D.
viii
The First CBT
Travel Guide to ACT
Acceptance and commitment therapy (ACT; said as a single word) and its underlying research
program in language and cognition, relational frame theory (RFT), has always been a part of
cognitive behavioral therapy (CBT) writ large, provided only that CBT is understood to include
modern behavior analysis. ACT challenges some of the assumptions of other parts of the CBT
family of therapies, and it is increasingly showing that it ofers a parsimonious approach with a
surprisingly broad impact. Consequently, as ACT has gained visibility and demonstrated viabil-
ity, it has been the target of a great deal of commentary and criticism from various wings of
behavioral and cognitive therapy. Te interest is actually a compliment, but sometimes the heat
from these exchanges obscures the fact that ACT and traditional CBT are related, despite their
diferences. And the heat behind these exchanges can readily leave out clinicians, who are not
interested in arcane scientifc battles so much as learning new, empirically supported ways to
make a diference with the people they serve.
Te present volume is the frst written in a way that invites CBT practitioners to explore the
ACT model to a degree that fts their interests. Readers do not have to check their assumptions and
beliefs at the door in order to explore. Hard-won competencies are empowered, not ridiculed. Less
about I’m right; you’re wrong, this book is about let’s see or even let’s play.
It is quite possible to integrate ACT methods into traditional CBT. It is equally possible to inte-
grate some CBT methods into an ACT model. Tis book will help readers in these eforts, and if
