‘Brief Acceptance’ refers to what we have come to call Brief Acceptance Therapies.
This is an umbrella term for a number of therapeutic and coaching systems that have Acceptance at the heart.
We are intentionally using this description in a vague and flexible way. It covers some of the more formal acceptance-based therapy models, such as:
- Acceptance and Commitment Therapy
- Dialetical Behaviour Therapy
- Mindfulness Based Stress Reduction
- Mindfulness Based Cognitive Therapy
Yet, we also use the term to refer to self-help strategies such as:
- The Work
- The Option Method
The content and aim of these various modalities are not identical. However, they share a common core, which is Acceptance.
We address this question on our About page. However, it may be worth repeating.
The word ‘brief’ is being used in two ways. Firstly, it is a nod to ‘brief therapy’ – often understood as a commitment to work with clients in less than 12 sessions. To prolong therapy beyond such a time-frame is considered counter-productive. An example of Brief Therapy is Solution-Focused Brief Therapy, which focuses on a client’s resources and employs a future-orientation. This is in contrast to traditional therapies which might be more inclined to focus on the ‘problem’ being discussed and seeking to back-track to the root of the issue.
Secondly, we are using the term brief to advocate for temporary acceptance. Clients newly introduced to Brief Acceptance Therapies can struggle with the idea of accepting unpalatable situations. To be told that, in order to move forward, they merely need to accept reality as it is for now, can be accessible and empowering.
Acceptance and Commitment Therapy (ACT) gets it name from one of its core messages: to accept what is out of your personal control, while committing to action that will improve your quality of life.
The aim of ACT (which is pronounced as the word ‘act’, not as the initials A.C.T.) is to help people achieve psychological flexibility and create a rich full and meaningful life. It seeks to do this by:
a) Teaching psychological skills to deal with painful thoughts and feelings effectively – in such a way that they have much less impact and influence over you. (These are typically as mindfulness skills.)
b) Helping clients to clarify what is truly important and meaningful to them – ie their values – then use that knowledge to guide, inspire and motivate them to change their lives for the better.
Mindfulness is a mental state of awareness, focus and openness – which allows you to engage fully in what you are doing at any moment. In a state of mindfulness, difficult thoughts and feelings have much less impact and influence over you – so it is hugely useful for everything from full-blown psychiatric illness to enhancing athletic or business performance. In many models of coaching and therapy, mindfulness is taught primarily via meditation. However, in ACT, meditation is seen as only one way amongst hundreds of learning these skills – and this is a good thing, because most people do not like meditating! ACT gives you a vast range of tools to learn mindfulness skills – many of which require only a few minutes to master.
This question is answered in detail by Steven Hayes, here.
Here is our very basic answer:
Generally, Cognitive Behavioural Therapy works to challenge distressing thoughts by looking for evidence and coming up with a more rational response. However, in ACT, the thought is accepted as a thought, e.g. “I’m having the thought that this plane is going to crash”, and then defused using a variety of techniques, including mindfulness.
Or, as Hayes writes:
If you want to pick one of the most salient differences, pick defusion (also known as deliteralization). In ACT, a troublesome thought might be watched dispassionately, repeated out loud until only its sound remains, or treated as an external observation by giving it a shape, size, color, speed, or form. A person could thank their mind for such an interesting thought, say it very slowly, or label the process of thinking (“I am having the thought that I am no good”). They might note how the back and forth of a mental argument is like a volley ball game and then literally play that out while watching from the sidelines. There are perhaps 100 defusion techniques that have been written about somewhere in the ACT literature. Not a one of them involves evaluating or disputing these thoughts.
The following page is regularly updated and contains links to papers and experiments on the effectiveness of Acceptance and Commitment Therapy:
The Serenity Prayer was first composed by the North American theologian, Reinhold Niebuhr (1892–1971). The shortest and most well-known version is:
God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.
A fuller version, attributed to Niebuhr in 1951, says:
God, give me grace to accept with serenity
the things that cannot be changed,
Courage to change the things
which should be changed,
and the Wisdom to distinguish
the one from the other.
Living one day at a time,
Enjoying one moment at a time,
Accepting hardship as a pathway to peace,
Taking, as Jesus did,
This sinful world as it is,
Not as I would have it,
Trusting that You will make all things right,
If I surrender to Your will,
So that I may be reasonably happy in this life,
And supremely happy with You forever in the next.
Niebuhr himself admitted that the prayer ‘may have been spooking around for years, even centuries.’ In fact, there are hints of it in Epictetus in the first century CE:
“Make the best use of what is in your power, and take the rest as it happens. Some things are up to us and some things are not up to us. Our opinions are up to us, and our impulses, desires, aversions-in short, whatever is our own doing. Our bodies are not up to us, nor are our possessions, our reputations, or our public offices, or, that is, whatever is not our own doing.”
The 8th-century Indian Buddhist scholar Shantideva reasoned similarly:
If there’s a remedy when trouble strikes,
What reason is there for dejection?
And if there is no help for it,
What use is there in being glum?
Finally, the Jewish philosopher Solomon ibn Gabirol wrote, in the 11th century:
‘And they said: At the head of all understanding – is realizing what is and what cannot be, and the consoling of what is not in our power to change.’
This question was answered by Steven Hayes, here:
Some of the highlights include:
The ACT literature is just now getting large enough to consider whether its impact is differential based on SES, ethnicity, gender, nationality, and the like. So far the news is good.
…A six hour ACT workshop with patient education works significantly better than a six hour patient education workshop alone in producing changes in diabetes self-management and blood glucose (at 3 month follow-up). The study was done at a public health clinic in a poor and largely Latino and Asian section of East Palo Alto. The percentage of minority participants was 76.5%.
…Aa 9 hour ACT protocol reduced seizures in epileptics 96% (90& were seizure free at a one yar follow up), while an attention placebo had no effect. The participants were all poor South African blacks living in a residential center.
…As for gender, in all of the studies so far ACT works as well for women as men, except for one analogue pain study in which it worked better for women. By the way, there is some indication that ACT helps with racial prejudice directly.
In Lillis & Hayes (2007) undergraduates enrolled in two separate classes on racial differences were exposed Acceptance and Commitment Therapy and an educational lecture drawn from a textbook on the psychology of racial differences in a counterbalanced order. Results indicate that only the ACT intervention was effective in increasing positive behavioral intentions at post and a 1-week follow-up. These changes were associated with other self-reported changes that fit with the ACT model.
Overall, so far as we can tell, ACT works well in different ethnic, cultural, national, and socio-economic groups; and works for both men and women. We shall learn more as the data comes in, but it is pretty cool that ACT researchers are already refusing to limit their work for middle class majority populations. A similar thing can be said for cognitively disabled populations, as the psychosis data are showing.
Dialectical Behavior Therapy (DBT) is a cognitive behavioural treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the recommended psychological treatment for such people. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.
DBT includes four sets of behavioral skills.
Mindfulness: the practice of being fully aware and present in this one moment
Distress Tolerance: how to tolerate pain in difficult situations, not change it
Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
Emotion Regulation: how to change emotions that you want to change
The term “dialectical” means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).
Mindfulness-Based Cognitive Therapy is designed to help people who suffer repeated bouts of depression and chronic unhappiness.
It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.
MBCT was developed by Zindel Segal, Mark Williams and John Teasdale, based on Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction program.
Developed by Jon Kabat-Zinn at the University of Massachusetts Medical Centre, Mindfulness-based Stress Reduction is based on mindfulness meditation.
Mindfulness is a basic human quality, a way of learning to pay wise attention to whatever is happening in your life that allows you a greater sense of connection to your life inwardly and outwardly.
Mindfulness is also a practice, a systematic method aimed at cultivating clarity, insight and understanding. In the context of your health, mindfulness is a way for you to experientially learn to take better care of yourself by exploring and understanding the interplay of mind and body and mobilizing your own inner resources for coping and growing.
Some of the skills people learn in MBSR courses:
- Practical coping skills to improve your ability to handle stressful situations
- Methods for being physically and mentally relaxed and at ease
- Gentle full body conditioning exercises to strengthen the body and release muscular tension
- To become increasingly aware of the interplay of mind and body in health and illness
- To face change and difficult times in life with greater ease
Nearly three decades of scientific research all over the world suggest that training in mindfulness and MBSR can positively and often profoundly affect participants’ ability to reduce medical symptoms and psychological distress while learning to live life more fully.
In DBT, Distress Tolerance skills are used when we are unable, unwilling, or it would be inappropriate to change a situation. It’s important to use the right skills at the right time. In order to change a situation or emotion, we would use Emotion Regulation skills.
Distress Tolerance skills are used to help us cope and survive during a crisis, and helps us tolerate short term or long term pain (physical or emotional pain).
We don’t know Byron Katie personally, so are in no position to comment on her as a person.
‘The Work’ – which is what Katie calls her method of self-inquiry has been experienced as a useful tool by many people. The ideas contained within are not original, but the way they are worded – including what is said and what is not said – make it a useful process.
After asking the four questions of The Work, you are provided with a ‘turn-around’. This is simply an invitation to look at your issue from a number of different perspectives. It is potentially a very powerful climax to the process, but should be handled with care. If someone is facing trauma or emotionally vulnerable, there is a risk that the turnaround could lead to the acceptance of potentially unhelpful thoughts. Instead, it should be remembered, that The Work is not seeking to reveal the ‘truth’ of a situation, but helping you find a way to accept and engage with reality. If the turnaround you come up with leaves you in a worse condition than the initial issue being worked-on, keep going until you come up with something else.
The following answer is taken from Byron Katie’s website:
The Work doesn’t say what anyone should or shouldn’t do. We simply ask: What is the effect of arguing with reality? How does it feel? This Work explores the cause and effect of attaching to painful thoughts, and in that investigation we find our freedom. To simply say that we shouldn’t argue with reality is just to add another story, another philosophy or religion. It hasn’t ever worked.
The following description is taken from, Byron Katie’s Four Questions:
You write down your stressful thoughts, and then ask yourself the following four questions:
Question 1: Is it true?
This question can change your life. Be still and ask yourself if the thought you wrote down is true.
Question 2: Can you absolutely know it’s true?
This is another opportunity to open your mind and to go deeper into the unknown, to find the answers that live beneath what we think we know.
Question 3: How do you react—what happens—when you believe that thought?
With this question, you begin to notice internal cause and effect. You can see that when you believe the thought, there is a disturbance that can range from mild discomfort to fear or panic. What do you feel? How do you treat the person (or the situation) you’ve written about, how do you treat yourself, when you believe that thought? Make a list, and be specific.
Question 4: Who would you be without the thought?
Imagine yourself in the presence of that person (or in that situation), without believing the thought. How would your life be different if you didn’t have the ability to even think the stressful thought? How would you feel? Which do you prefer—life with or without the thought? Which feels kinder, more peaceful?
Turn the thought around:
The “turnaround” gives you an opportunity to experience the opposite of what you believe. Once you have found one or more turnarounds to your original statement, you are invited to find at least three specific, genuine examples of how each turnaround is true in your life.
Emotional Freedom Techniques (EFT) is a form of counselling intervention that draws on various theories of alternative medicine including acupuncture, neuro-linguistic programming, energy medicine, and Thought Field Therapy (TFT). EFT and similar techniques are often discussed under the umbrella term “energy psychology”.
Advocates claim that the technique may be used to treat a wide variety of physical and psychological disorders, and as a simple form of self-administered therapy.
Proponents of EFT and other similar treatments believe that tapping/stimulating acupuncture points provide the basis for significant improvement in psychological problems.
Bruce Di Marsico created what he called the Option Method nearly 40 years ago.
According to their own blurb:
The Option Method is a highly effective way to help with depression, stress, anxiety, frustrations, relationship and marriage problems, and improve mental health. By asking carefully designed Option Method questions, anyone can discover the beliefs and attitudes underlying their depression and unhappiness.
The most basic difference between Option and other methods is the understanding that we are our own best experts. We each have our own, individual, specific, reasons for getting unhappy when we do. The Option Method Questions are designed to help us identify those reasons. Unlike other modalities, the Option Method does not require you to rethink, memorize or adopt a new belief or thought pattern. The Option Method Questions present a painless process that allows you to simply let go of self-defeating beliefs.
The Option Method Questions are:
- What are you unhappy about? (identify)
- What do you mean? (clarify)
- Why are you unhappy about that? (identify)
- What do you mean? (clarify)
- What are you afraid would happen or…
- What are you afraid it would mean if you were not unhappy about that?
- Why do you believe it would mean that?
Bruce Di Marsico designed and created this series of questions so that we may help ourselves reveal the beliefs behind our bad feelings and unhappiness.
EFT may be thought of as kinaesthetic hypnosis.
Regardless of any meridian points or suchlike, EFT seems to work because the added somatic element helps those clients who are perhaps less inclined to function cerebrally. That is, the added physical element allows clients to take on board the spoken affirmations.
The words spoken during an EFT session are not insignificant:
Even though [fill-in issue statement], I love and accept myself completely.
Example: Even though I worry about my teenage daughter, I love and accept myself completely.
It can therefore be seen that the core of EFT is a bodily experience of acceptance.