ACT Book Summary: Pages 219 - 229

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These pages concern how to differentiate goals from values, methods to clarify values, ways to elicit actions related to values and how to evaluate barriers to valued action.

Outcome is the Process through which Process Becomes the Outcome

This section relates how needing to attain goals creates motivation and direction for action, but does not provide vitality in life. Attaining goals does not equal happiness or life satisfaction, as one is forced to live in a constant state of deprivation (interestingly, it is pointed out that the etymology of the word "want" is "missing").

The Gardening Metaphor describes how to stick it out with an initial choice (i.e., value) to see what happens (without believing that the "grass is greener on the other side," no pun intended). Another "goal" in this phase of therapy is to help clients see that the process of living equals the outcome of interest. The Skiing Metaphor describes this well. Your stated "goal" may be to get down to the lodge and you are planning to ski there. If someone whisks you off in a helicopter to bring you to the lodge, that would make you mad. It is the process of getting to the lodge (i.e., skiing) that is what is to be enjoyed.

Finally, process cannot be measured from moment to moment like goals. If one continually monitors progress toward specific goals, they may miss the " big picture" (i.e., what they have accomplished to date). Here the Path up the Mountain Metaphor comes into play. It highlights what is wrong with monitoring only "snapshots" of life. If you are hiking up a mountain, you may notice twists and turns, circling around (perhaps even going down the path in parts) ultimately to get up the mountain. You may think at any given time: "I'm doing well" (for instance on an up-path) or conversely: "I'm doing poorly" (on a down-path). Yet, an observer with binoculars across the way (looking down at the hikers) may notice steady, continuous progress toward the overall goal.

Values Clarification: Setting the Compass Heading

In this section, values work is further elaborated. The authors point out that doing values work can be an intimate experience between therapist and client, as oftentimes values are not something the client has ever articulate before to someone else. One of the "values" of "values work" is in the fact that values may help point out to clients what IS working in their lives (i.e., they may be leading valued lives in certain areas they hadn't even recognized). There are some values worksheets on page 224. There are three forms, including a values narrative form, values assessment rating form, and goals, actions, barriers form you can use with clients. The goal is to review the worksheets together and build on them. Values work may be a helpful assessment tool as well. In doing the values work, therapists can uncover possible "ulterior motives" for certain values. The authors give three examples:

  1. when values statements are controlled by the presence of the therapist, the consequence can be therapist approval or lack of disapproval.
  2. when values statements are controlled the presence of the culture more generally, the consequence can be the absence of cultural sanctions, broad social approval, or prestige.
  3. when values statements are controlled by stated or assumed values of the client's parents, the consequence can be parental approval

This is not to say that these factors don't affect EVERYONE'S values, but the extent to which the client takes ownership of their values is important to assess. When a client is wedded to the consequences mentioned above, the therapist can ask the client what would happen if the stated consequences were not there (i.e., "What if your parents did not know you received a Ph.D.?"). Another point the authors make is that it is not uncommon for values to change in valence over the course of therapy. Sometimes (oftentimes) clients may leave certain (or many) domains completely empty. In this situation it can be helpful for the therapist to ask the client what values he/she held earlier in life.

Assessing Goals and Actions

After values work is underway, the focus is on developing goals and specifying the actions that can be taken to achieve those goals. A goal is define as a specific achievement, accomplished in the service of a particular value. Clients do homework in acting according to values either as a one-time deal or from a commitment to repeated and regular acts in the service of a given value. The therapist and client monitor for a close connection between action, goal, and value and try to "accumulate small positives." The authors assert that little steps consistently taken are more useful than heroic steps taken inconsistently. What to do about barriers? The authors mention that engaging in valued action almost always provokes a psychological reaction (often in the form of barriers). At these times, clients may get stuck because they avoid taking values actions as a means of avoiding painful emotional barriers. The therapist then helps the client examine:

  1. the type of barrier
  2. ask if the barrier is something they can make room for and still act
  3. find out what aspect of the barrier may actually help reducing your willingness to have it without defense
  4. assess whether barriers are a form of emotional control or avoidance

Question

Although I am a big proponent of values work (or I wouldn't be doing this therapy), I am still struck by the similarity of values homework to "monitoring progress toward a goal," not noticing the process itself. In other words, the question "How well did you move toward this goal this week by these actions" seems like the very "snapshot" that is proposed as problematic in the initial part of this section. Any reactions?