Table Of ContentPSYCHOLOGY
An in-depth, integrated approach
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Trauma‑Focused
to help clients heal from trauma
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Trauma-Focused ACT (TFACT) provides a flexible, comprehensive model for treating
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the entire spectrum of trauma-related issues, including post-traumatic stress disorder
m ACT
(PTSD), addiction, depression, anxiety disorders, moral injury, chronic pain, shame,
suicidality, insomnia, complicated grief, attachment issues, sexual problems, and more.
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Written by internationally acclaimed ACT trainer, Russ Harris, this textbook is for
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practitioners at all levels of experience, and offers exclusive access to free downloadable
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resources—including scripts, videos, MP3s, handouts, and worksheets.
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Discover cutting-edge strategies for healing the past, “The definitive book for treating c
living in the present, and building a new future. With trauma‑related difficulties u
this compassion-based, exposure-centered approach, with compassion, courage, and
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you’ll learn how to help your clients: cutting‑edge scientific tools.” A Practitioner’s Guide to
e
—Todd B. Kashdan, PhD, professor of
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• Find safety and security in their bodies psychology, and author of Curious?
Working with Mind, Body & Emotion Using
• Overcome hyperarousal and hypoarousal “One of the clearest writers
A
and most creative practitioners
• Break free from dissociation
in the ACT community. C
Acceptance & Commitment Therapy
• Shift from self-hatred to self-compassion I learned something new
in every subsection. T
• Rapidly ground themselves and reengage in life
Highly recommended.”
• Unhook from difficult cognitions and emotions
—Steven C. Hayes, PhD,
originator of ACT
• Develop an integrated sense of self
H
• Transform traumatic memories through “Beautifully written and
intensely practical … I consider
flexible exposure A
it the ACT book for trauma.”
• Connect with and live by their values —John P. Forsyth, PhD, coauthor of R
The Mindfulness and Acceptance
• Experience post-traumatic growth
Workbook for Anxiety R
I
RUSS HARRIS is a medical practitioner, psychotherapist, and internationally acclaimed S
ACT trainer. He is also author of the popular guide to ACT: the million-copy best-seller,
The Happiness Trap.
C P
ontext ress
An Imprint of New Harbinger Publications, Inc.
R U S S H A R R I S
www.newharbinger.com
Context
Press
“Trauma-Focused ACT is going to go down as one of the great contributions to the field of trauma-
informed care. Written in a highly accessible, practical style, Harris provides the acceptance and com-
mitment therapy (ACT) therapist with a comprehensive, step-by-step approach to working with
traumatized clients. The book is chock-full of tidbits of clinical advice that could only come from a
highly skilled therapist with loads of experience working with trauma. If you read this book from cover
to cover (and maybe read it again), you will have a complete sense of how to roll out, manage, and
complete a high-potency treatment with a traumatized client. There aren’t many books out there that
achieve this high ground, and this is one of them! Highly recommended.”
—Kirk Strosahl, PhD, cofounder of ACT, and coauthor of Brief Interventions
for Radical Change
“This beautifully written and intensely practical book offers a rich array of clinical insights and strate-
gies covering the many nuances and concerns that show up when working with various forms of
trauma from an ACT point of view. I consider it the ACT book for trauma, and a must-read for mental
health practitioners who are looking for a compassionate and transformative approach to helping their
clients heal old wounds and engage their lives now in ways that matter to them.”
—John P. Forsyth, PhD, coauthor of The Mindfulness and Acceptance Workbook for Anxiety
and Acceptance and Commitment Therapy for Anxiety Disorders
“Nobody writes with greater clarity and offers more concrete, useful, and innovative suggestions and
strategies than Russ Harris. This is the definitive book for treating trauma-related difficulties with
compassion, courage, and cutting-edge scientific tools.”
—Todd B. Kashdan, PhD, professor of psychology, and author of Curious?
and The Upside of Your Dark Side
“This book is a major milestone in understanding how ACT can support recovery from trauma. In this
comprehensive manual, Russ Harris provides rationales, exercises, and transcripts to give therapists
clear guidance on working effectively with the full range of problems associated with trauma. From
hypervigilance, reexperiencing, avoidance, freezing, and dissociation to responses of shame and guilt—
Trauma-Focused ACT provides numerous sensitive, respectful, and progressive ways to work with
clients. Written with warmth and compassion, this is the indispensable guide for using ACT to help
people with trauma.”
—Eric Morris, PhD, senior lecturer and psychology clinic director at La Trobe University,
and coauthor of Acceptance and Commitment Therapy for Psychosis Recovery
“We’ve known for a long time that psychological flexibility skills are very important in addressing
trauma, but we’ve had a harder time creating trauma-focused versions of ACT that can establish those
skills. This book helps fill that gap, from one of the clearest writers and most creative practitioners in
the ACT community. I learned something new in every subsection. Highly recommended.”
—Steven C. Hayes, PhD, Nevada Foundation Professor in the department of psychology
at the University of Nevada, Reno; and originator of ACT
“Another gem from Russ Harris. Trauma work can be daunting—fraught with anxiety and vulnerabil-
ity on the part of the therapist. By the end of the opening paragraph, you will feel your shoulders relax
and know you are in capable and compassionate hands. It’s all here: from the best, most accessible
description of the polyvagal theory you’ll find, to the careful construction of exposure hierarchies.
Even as you venture into especially challenging areas such as suicidality or moral injury, Russ Harris
provides a solid framework and proven strategies for helping clients with traumatic histories to live the
life they want and deserve. An absolute must for anyone doing this important work.”
—Chris McCurry, PhD, clinical psychologist, and author of Parenting Your Anxious Child
with Mindfulness and Acceptance
“This book is full of wonderful guidance on how to help those with post-traumatic stress disorder
(PTSD), and provided me with many new exercises and insights into this disorder. If you work in this
area, read this book.”
—Michael P. Twohig, professor at Utah State University, and coauthor of ACT in Steps
“A trademark of Russ Harris is his ability to break ACT down into language that’s clear, pragmatic,
and clinically useful, and to illustrate ideas with great practitioner-client dialogue. And Trauma-
Focused ACT is no exception. What jumped out at me with this book was how thoroughly it explores
the nuances of ACT in the context of trauma. If you are after guidance about how to use ACT in this
domain, then this book leaves no stone unturned.”
—Nic Hooper, senior lecturer of psychology at University of the West of England, and
author of The Unbreakable Student
“Trauma-Focused ACT is a great book. It speaks to therapists in a really accessible way, helping them
to understand trauma in a way that will be supremely useful to their clients. The book gives a wide
range of tools and strategies that are psychologically well-informed, compassionate, and based on solid
scientific evidence. The book integrates perspectives from neuroscience, psychology, and a number of
forms of evidence-based psychotherapy—all from within a coherent ACT framework. This book is an
essential resource for all therapists.”
—David Gillanders, head of clinical psychology at the University of Edinburgh
“Russ Harris has once more written a simple, practical, comprehensive, easy-to-follow, state-of-the-art
textbook that is an essential read for both novice and experienced clinicians. Each chapter is rich with
examples, transcripts, metaphors, worksheets, tips, and common pitfalls that enable the reader to both
deliver the intervention with confidence and gain a deeper understanding of the ACT model and
approach to trauma. Couching the whole approach in cutting-edge research adds to the value of this
book as a great resource and an absolute must-have in any clinician’s toolbox.”
—Maria Karekla, PhD, associate professor at University of Cyprus,
and coauthor of Cravings and Addictions
“I always appreciate Russ Harris’s books in their ability to clearly communicate concrete, practically
useful information on ACT in an accessible way that’s helpful for newer and more advanced practitio-
ners alike. This book achieves that once again, containing an impressive collection of insightful per-
spectives, tips, and exercises that are coherently integrated within an overarching model of delivering
trauma-focused ACT (TFACT). It provides a notably in-depth exploration of how ACT can be tai-
lored to individuals with trauma, including adaptations to common ACT exercises, strategies for over-
coming challenges, and integrating other relevant theories in this area.”
—Michael Levin, PhD, associate professor at Utah State University,
and coeditor of Innovations in Acceptance and Commitment Therapy
“Trauma-Focused ACT is essential reading for all ACT practitioners working with clients who have
experienced trauma. The book provides cutting-edge and up-to-date coverage of ACT theoretical
concepts and practical innovations for practitioners. Russ never fails to impress with his accessible yet
theoretically on-point exploration of the topic.”
—Louise McHugh, professor in the school of psychology at University College Dublin,
and coauthor of A Contextual Behavioral Science Guide to the Self
“Russ Harris’s ACT publications are renowned for being incredibly accessible and clinically useful. I
can honestly say that with Trauma-Focused ACT, Russ has outdone himself. At every step along the
journey, Russ generously offers modifications and practical tips to help us when things don’t go accord-
ing to plan, while keeping us grounded in the science of ACT. Trauma-Focused ACT is an important
clinical resource that truly honors the complexity of human suffering and the interpersonal therapeu-
tic endeavor.”
—Sheri Turrell, CPsych, peer-reviewed ACT trainer; coauthor of ACT for Adolescents
and The Mindfulness and Acceptance Workbook for Teen Anxiety; psychoanalyst; and
adjunct lecturer at the University of Toronto
“This is an excellent, comprehensive, contemporary, and instructive guide on how to conduct TFACT.
Importantly, consistent with the ACT framework, the TFACT approach is sensitively person-focused,
holistic, and open to incorporating empirically supported strategies from different therapy models.
Russ describes TFACT in a very accessible and practical way, with lots of illustrative therapist-client
transcripts, worksheets, and other useful clinical tools. This book will serve as an excellent resource
for clinicians at any level and from any theoretical orientation in their delivery of empowering support
to people whose lives are constrained by the pain of trauma.”
—Kenneth Pakenham, PhD, emeritus professor of clinical and health psychology at
The University of Queensland, and author of The Trauma Banquet
“ACT is a powerful therapeutic approach to working with trauma and its complex associated issues,
such as complicated grief, identity issues, and shame. Russ Harris has pulled together all the latest
cutting-edge research and practice into a manual that is broad and deep in its theoretical and practical
application. If you work with clients who experience trauma, then this is a must-buy for your bookshelf,
that you will find yourself constantly reaching for.”
—Joe Oliver, founder of Contextual Consulting, and coauthor of The Mindfulness
and Acceptance Workbook for Self-Esteem
“I am profoundly grateful for this book. Russ Harris has applied his masterful ability to make complex
ACT concepts highly accessible to the vitally important and often enigmatic treatment of trauma.
Filled with exercises, metaphors, and handouts, this book offers dozens of fresh tools for your practice.
The addition of the essential physiological factors which often accompany trauma is critical to the
understanding of its treatment and is sure to enrich your clinical conversations. Russ walks us through
dialogues with clients demonstrating a brilliant clinician’s understanding of the importance of weaving
compassion and dignity into sessions. He will leave you with little doubt that you can hold challenging
sessions with trauma survivors. If you work with clients with trauma, this is a must-read text.”
—M. Joann Wright, PhD, fellow of the Association of Contextual Behavioral Science,
peer-reviewed ACT trainer, and coauthor of Learning ACT for Group Treatment and
Experiencing ACT from the Inside Out
“As a psychotherapist, whether you work with traumatized patients or not, this book is for you. With
his usual simple but precise language, Russ Harris leads you through applying your ACT skills to
simple or complex trauma. This well-designed model—based on four flexible stages of intervention—
encourages therapists to apply ACT according to personal style, experience, and creativity.”
—Nanni Presti, professor at Kore University of Enna, Sicily
“Russ Harris did it again—gifting us a guide about a complex clinical issue, written in a simple yet
comprehensive way that distills the latest insights about trauma-focused clinical work. Trauma-Focused
ACT is unique in its wide applicability: It will give you a firm framework for your clinical work while
also leaving—and emphasizing—space and opportunities to flexibly adapt the framework to each of
your individual clients. For experienced ACT therapists, it will be a source of inspiration how to
further tweak and refine their trauma-focused work.”
—Valerie Kiel, psychologist, and peer-reviewed ACT trainer
“Russ Harris excels in making complicated stuff comprehensible. If you have experience with ACT for
some time and now want to start working with people who have experienced trauma, this book is for
you. If you have worked treating people who have experienced trauma and now want to start using
ACT, this book is for you. In a very structured yet flexible way, Russ Harris guides you through the
important aspects of trauma and the six core processes of ACT. The work comes to life with the many
case examples and dialogues that help you understand how to address important issues.”
—Jacqueline A-Tjak, PhD, clinical psychologist, and peer-reviewed ACT trainer
“This manuscript is an invaluable resource for clients wrestling with any form of traumatic experi-
ence—guiding them to get back into their life, move beyond trauma, and find themselves again. It’s
written with so much compassion and knowledge, and it’s full of resources that demonstrate—page by
page—how ACT can make a difference when working with trauma-related matters. If you’re a clini-
cian working with trauma, passionate about third-wave therapies, this is a must-read book!”
—Patricia E. Zurita Ona, PsyD, author of The ACT Workbook for Teens with OCD
and Acceptance and Commitment Therapy for Borderline Personality Disorder
“In the spirit of his go-to clinical text, ACT Made Simple, Russ Harris has produced another vital and
practical resource for clinicians working with trauma. Trauma-Focused ACT presents a user-friendly,
yet sophisticated, model of case conceptualization, treatment planning, and cutting-edge interven-
tions derived from ACT and informed by the latest science on trauma. Russ walks the reader through
countless case examples and clinical exchanges to help translate principles into practice, emphasizing
the safety and willingness of the client throughout the stages of therapy. Given the high prevalence
and varied manifestations of trauma across cultures and populations, this book is sure to be of great
value to clinicians.”
—Lou Lasprugato, marriage and family therapist, and peer-reviewed ACT trainer
“Russ Harris has an unusual ability to describe the work of ACT in a way that is both simple, clear,
and profound. He has shown this in his earlier books, and this one on treatment of trauma is yet
another example. The fact that he gives the concept of trauma a wide definition makes the book
highly relevant for most, if not all, therapists working with psychological suffering.”
—Niklas Törneke, MD, coauthor of Learning RFT and The ABCs of Human Behavior
Trauma‑Focused
ACT
A Practitioner’s Guide to
Working with Mind, Body & Emotion Using
Acceptance & Commitment Therapy
RUSS HARRIS
C P
ontext ress
An Imprint of New Harbinger Publications, Inc.
Publisher’s Note
This 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, finan-
cial, legal, or other professional services. If expert assistance or counseling is needed, the services of a compe-
tent professional should be sought.
Distributed in Canada by Raincoast Books
NEW HARBINGER PUBLICATIONS is a registered trademark of
New Harbinger Publications, Inc.
Copyright © 2021 by Russ Harris
Context Press
An imprint of New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Daniel; Acquired by Catharine Meyers;
Edited by Rona Bernstein; Indexed by James Minkin
All Rights Reserved
Library of Congress Cataloging-in-Publication Data
Names: Harris, Russ, 1938- author.
Title: Trauma-focused ACT : a practitioner’s guide to working with mind, body, and emotion using
acceptance and commitment therapy / Russ Harris.
Description: Oakland, CA : New Harbinger Publications, [2021] | Includes bibliographical references and
index.
Identifiers: LCCN 2021029333 | ISBN 9781684038213 (trade paperback)
Subjects: LCSH: Acceptance and commitment therapy. | Psychotherapist and patient. | Post-traumatic
stress disorder--Treatment.
Classification: LCC RC489.A32 H375 2021 | DDC 616.89/1425--dc23
LC record available at https://lccn.loc.gov/2021029333
Printed in the United States of America
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10 9 8 7 6 5 4 3 2 1 First Printing
To my beloved Natasha: my friend, my companion, my advisor, my supporter, my teacher,
my mentor, my guide…and the absolute love of my life. So many times, I wanted to give up—
but you kept me going. So many times, I was stuck—and you helped me out. Volim te zauvek.
