Mindfulness and Acceptance Workbook for Depression - a group process

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I am using the Mindfulness and Acceptance Workbook for Depression in a group format at Lehman College, and will document my findings here. I did look at the resources here to see who has done depression groups or groups in general from an ACT perspective, and what I have found has been helpful.

Setting: Lehman College
I work in an Urban setting with a multicultural population of student in a commuter college where students work 20 hours a week and balance a full time course load and family responsibilities. Despite these issues, I have managed to facilitate three brief CBT groups: One on Depression, one on Anxiety and one on Social Anxiety. I trained at the Albert Ellis Institute, and last year I took a one day ACT workshop there, and in the summer at Cape Cod a week with Steven Hayes.

Structure: Mindfulness and Acceptance Workbook for Depression
Brief summary of the text.
The first 5 chapters were very helpful and extremely explanatory with many helpful exercises, but how would I translate all of that into an introductory workshop.

I created PowerPoint slides to make it an educational / experiential experience.
I have read the book twice and I bought extra copies for my staff at the Center.
Clinical staff participated in creating this group structure, and the PowerPoints of all of the steps, to simplify the content, noting when there was an exercise to hand out and when there was an audio exercise.
We've had to decide which exercises to do together, and which to give to he students to do at home.
There were many exercises
There were many audio exercises

The CD came in handy as many of the exercises in the book where in the CD, but they were not organized, so I had to print them out and then asked support staff to find the one's that belong to each chapter.
Next time, the CD should have it organized by chapter, or note on the print out which chapter it belongs too. The CD has audio too, but in some computers the audio will not upload and in other computers it does. I had to upload them to itunes, and I had to make itunes my default in order to hear them or else they would not upload on windows. Very strange. This frustrated me.

Although I love this text, and the exercises, I need to make ACT as simple as possible for the students I am seeing, this is a new paradigm that leaves them scratching their heads.
Reading ACT made simple by Russ Harris, helped tremendously, and although I am invested in the Strosahl and Robinson text, every so often I take a peek at Harris's book for simplicity.

It is hard to have a group in a college setting, particularly in a commuter college where students are not as invested in staying behind to participate in a group or workshop. However, we are committed to groups and workshop, and so we persist.

I queried the college students via mass email to students, and facebook, flyers at the Center and throughout the college, but we decided to Pilot the group with students who were already clients at the Center, and whom we knew.

We are opened Saturday, and ten students who responded stated they wanted Saturdays.
The first session the weather was horrible, and attendance has been poor, but students came to see us to catch up on what they missed.

We started the group late in March, and as the semester is ending soon(May15th). We can only keep the student's attention for a limited time so we decided to do the 9 steps in 6 weeks.
This has been a challenge, taking these 9 steps and making them 6 has not been easy.
As this is a pilot study to see how this works, or doesn't, we have decided to be compassionate, mindful and curious about this process.

March
Session 1
We completed the Intro - that was intense - too much explanation when the model should be experienced not explained.
We decided to be careful about this.
We did some of the exercises, but not a lot of them as they were too many for the students.
Five students of ten confirmed.
Two attended and the one who called in late did not make it.

Session 2 - Step 1 & Step 2 - Canceled -
Our second session was disrupted by a horrible snow storm, so we couldn't meet.
During that week students who did not make it came in to see us individually and make up the missed session, all individual meetings were productive.

Session 2 - Step 1 & Step 2 - Little Hurricane in New York
We have never seen anything like this, but there was a little mini hurricane in NYC, everything was flying around, the windows almost felt like they would shatter.

We held the session anyway, and we were shocked that 2 our of five students made it. One had an emergency and had to leave.

Interruption - Spring break in interrupted the group this week and now we are almost starting a new this Saturday.

Session 3 - Step 3 & Step 4 for Saturday 4/10/10
Due to interruptions we decided to create a review session of Session 3, and review what everyone has missed, and do as much of what we have to do for this session.

I will need to take the last 3 session and make them into simplified slides and give them an outline to read.
Some of the students wanted to concepts on index cards particularly the words "fusion" and "defusion" and "Psychological Flexbility" and "Acceptance" and so we are thinking of creating a sheet with important terms.

I created a private blog for this group in order for students to communicate or keep in touch with what is missed if they do not come, as I am committed to ACT and to this particular workbook, but I am trying to see how to simplify it. http://mindfulpractice.wordpress.com/

I am in the process, however, of changing some of the content and simplifying it.
On Friday, I will query our group to confirm their attendance, and promise refreshments, tea, coffee and donuts and a simpler format that will catch their attention about "Becoming a Mind Watcher"

We may change the group from a Saturday to a Wednesday, we will ask our group about this.

Lastly, there were things in the text I couldn't do, for example telling student not to take medication etc. My staff reacted to that. Secondly, some of the students do react to the Stranded and the Write Your Epitaph exercise. The To Do Institute - Morita Therapy (http://www.todoinstitute.org/naikan3.html) has a similar exercise that does not include being stranded or being dead, instead it makes you visualize taking time for yourself in a retreat where your day to day needs are met so that you can reflect on your life, our values etc. Wonderful.