By Milton Spett

In his Sept. 25 workshop for NJ-ACT, Kelly Wilson explained that he developed the “values” component of Acceptance and Commitment Therapy. Wilson’s most important contribution is that ACT should first identify what the patient values most in life, and then focus on helping the patient to achieve these valued goals rather than focusing on symptom reduction. One way to identify a patient’s most valued goal is to ask “If you could choose anything, what would you want your life to be about?” Wilson’s Valued Living Questionnaire asks patients to rate how much they value each of ten life domains, such as family, work, marriage, friends, etc.

Wilson gave the example of a woman who consulted him for severe panic attacks with agoraphobia. This woman placed a high value on her family, and she knew her panic would prevent her from attending her daughter’s impending high school graduation. Wilson encouraged the woman to do each exposure exercise not to reduce her panic, but in order to attend her daughter’s graduation. According to Wilson, therapy should always focus on positive goals, achieving what one values in life, rather than on negative goals such as symptom removal.

Wilson believes that avoidance of emotions, thoughts, and memories is a key component of psychological disorders. He also believes that the intense experiencing of these internal events, without judging or trying to change them, is a critical component of effective therapy. He sees exposure as a critical component of all therapy, but to him, “exposure” means using mindfulness and imagery exercises to help patients to experience rather than avoid thoughts, feelings, and memories.

Acceptance and Commitment Therapy focuses on behavioral techniques to achieve valued goals, but asserts that cognitive techniques add nothing to the behavioral component of CBT. In fact, cognitive restructuring techniques violate Acceptance and Commitment Therapy’s basic assumption that dysfunctional cognitions should be accepted rather than disputed.

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