Core Processes/Metaphors Tracking
Have you ever had this situation: You are meeting with your sixth patient of the day and, in the therapeutic moment, you see a perfect opportunity to present a particular ACT metaphor....but you can't quite remember if you had done that other metaphor which sets the stage for this one.....and you ask "have we talked about the person in the hole yet?" Now, many of the perfect therapists on this list surely would never do this. However, for the rest of us, how do you keep track of what you have covered?
I designed the attached form (see bottom) for jotting down what I have covered. I sometimes review it prior to sessions along with progress notes from those earlier sessions. Now, granted, I still occasionally check-in about whether we covered an exercise/metaphor (no big deal), though less often and less awkwardly. You will note that the exercises and metaphors often target multiple core processes, so this form is just a coarse tracking guide. But I find it helpful.
Content of the Attachment
Page 1 is the form. Page 2 is an example of what it might look like after multiple sessions (metaphors/exercises would be hand-written, of course). Upon review, the sample on Page 2 contains far more actual content than the completed forms I have used with patients.
Using the Form
Time proceeds from middle (1st session) to out (in my use of it). Going from out to in results in much crowding of the content in the middle. It also makes it more difficult to get a sense for the progress of therapy (at a glance).
Using the Form for Self-Assessment
The form can also be used as a tool for ongoing self-assessment, revealing your therapy habits. For example, even a casual glance at some of my completed forms quickly revealed that I favor Values work and Cognitive Defusion, using a handful of mindfulness techniques, mostly for getting clients and myself into the Present Moment, less so in the service of promoting Self-As-Context. While this evident pattern may merely reflect my personal style in using ACT, it also challenges me to do some self-examination about processes that I may avoid (one's style is always a work in progress, right?). I also find it useful to compare completed forms to my responses on the ACT Core Competency Self-Assessment, an excellent learning tool available on this site.
Improvements and Revisions
Feel free to edit, change, and improve the Core Processes/Metaphors Tracking Form to fit your needs. If others have similar tools/guides or improve upon this form, please share the work!