Acceptance and Commitment Therapy (ACT) has gained traction since its inception in the 1980s, credited to Dr. Steven Hayes, a professor at the University of Nevada. Driven by his own battles with panic attacks, Hayes aimed to promote self-acceptance in the face of challenges. ACT engages clients in an action-oriented therapeutic approach that blends elements from behavioral therapy and cognitive behavioral therapy.
This therapy assists individuals in confronting and acknowledging their internal emotions rather than evading or denying them. By encouraging a deeper understanding of their feelings and experiences, clients are empowered to initiate positive behavioral changes. Additionally, ACT emphasizes discovering personal values that can help lessen overall distress.
ACT is based on the belief that stress is an unavoidable part of life. Emotions and various mental and physical health issues arise, often beyond our control. By fostering acceptance of these experiences, we can guide clients toward effective coping mechanisms, steering them away from avoidance tactics and equipping them to tackle their challenges directly.
ACT can be beneficial for a range of mental health disorders, such as anxiety disorders, depression, OCD, eating disorders, substance abuse issues, chronic pain, and workplace-related stress.
The therapeutic journey involves six essential core components: acceptance, cognitive defusion, being present, the self as context, values, and committed action. These principles help clients enhance their psychological flexibility, enabling adjustments in thoughts and behaviors to better match their values and objectives.
Goal Setting with Clients in Your Acceptance and Commitment Therapy Treatment Plan
The first phase of ACT treatment consists of a comprehensive assessment of the client’s thoughts, feelings, and behaviors. This will include exploring avoidance patterns, identifying the client’s values, recognizing cognitive fusion, and assessing their psychological flexibility. Furthermore, you will assist clients in discovering value-driven goals and evaluating their awareness of the present moment.
Your assessment will lay the groundwork for the subsequent acceptance and commitment therapy treatment plan—tailored specifically to your client and their current symptoms. It’s crucial that these goals are realistic and feasible based on their existing abilities.
As you formulate your treatment strategy, consider incorporating supplementary materials into your sessions. Worksheets can be particularly beneficial as they align with session objectives and encourage client engagement. Clients are also able to take worksheets home for personal reference. TherapyByPro offers a comprehensive array of clinical resources and worksheets for mental health professionals. Some useful worksheets to complement your ACT treatment plan may include:
Essential Elements in a Treatment Plan for Acceptance and Commitment Therapy
In the remaining sections of this article, we will highlight an example treatment plan for acceptance and commitment therapy, following the editable template provided by TherapyByPro. We will explore various sections of the treatment plan and discuss key details to consider. This example will revolve around a fictional client named John. Read on for John’s narrative.
John’s Narrative:
John is a 23-year-old male who has sought a psychological assessment at your outpatient mental health clinic due to ongoing symptoms of anxiety. In particular, John has difficulty managing excessive worry, which encompasses multiple issues such as academics, finances, and personal relationships. He has been grappling with these symptoms for approximately six months.
Besides his unmanageable worry, John experiences restlessness, frequent fatigue, trouble concentrating, irritability, muscle tension, and sleep issues. These symptoms have led to avoidance behaviors that allow him to suppress his worries instead of addressing them. He often has difficulty distinguishing his anxiety and fears from reality, leading him to make decisions influenced by his feelings, not aligning with his values or personal aspirations.
John has not reported any additional mental health issues, including suicidal or self-harming thoughts. He has no history of treatment and was encouraged by his parents to seek help after discussing his struggles and their impact on his academic performance. John has no medical concerns and remains in good academic standing, despite his ongoing challenges.
Agencies Involved and Care Coordination Plans
In this part of the treatment plan, you would document any other professionals or organizations your client is engaging with. Since John is not receiving treatment from any other providers, this section is not applicable in his case. In different scenarios, you might note other mental health professionals, EAP case managers, or primary care providers involved in the client’s care.
Example for John:
Care Coordination: None at present
Clinical Diagnoses
From the information gathered during John’s clinical assessment, he seems to meet the diagnostic criteria for Generalized Anxiety Disorder (GAD). The supporting symptoms for this diagnosis include:
- Chronic and intense worry
- Restlessness or feeling agitated
- Frequent fatigue
- Trouble focusing
- Irritability
- Muscle tension
- Disrupted sleep patterns
Example for John:
Clinical Diagnosis: Generalized Anxiety Disorder, ICD-10:F41.1
Current Medications and Responses
In this segment of your ACT treatment plan, you would document any medications your client is currently taking, which may include those for mental health conditions or medical issues, along with their dosages and the client’s response to these medications.
response to taking them.
Example for John:
Current Medications: None currently
Presenting Problem and Related Symptoms
In this section of the treatment plan, you’ll detail the client’s case conceptualization. This is crucial as it establishes the foundation for future treatment goals and objectives. You may refer back to this document in subsequent sessions or share it with other professionals involved in the client’s care.
Example for John:
John, a 23-year-old male, arrived well-groomed and punctual. He expressed his symptoms, which align with Generalized Anxiety Disorder (GAD). For the past six months, these symptoms have caused him considerable distress and dysfunction. He reported excessive and uncontrollable worries regarding academics, finances, and relationships. Moreover, he suffers from restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep issues. John noted a decline in his grades this semester as he struggles to concentrate on his studies. He elaborated that worrying about one assignment leads to an overwhelming cycle of anxiety, which feels unmanageable. As a result, he has had inconsistent attendance in classes.
His persistent worrying has resulted in avoidance behaviors, such as skipping classes, which further increase his anxiety and hinder meaningful engagement in activities. John’s current coping mechanisms involve avoidance and suppressing his anxiety symptoms. Although this gives him temporary relief, he understands it is not a sustainable strategy. He has no prior mental health issues or treatments and denies any current or past suicidal ideation (SI) or homicidal ideation (HI). His parents have encouraged him to seek professional help, and he seems open and dedicated to receiving treatment.
Goals and Objectives
This part of your acceptance and commitment therapy (ACT) treatment plan should outline well-defined goals and objectives. These should be achievable based on your client’s current capacities and the timeframe available. Additionally, ensure that these goals are in line with ACT’s core principles and treatment trajectory.
Example for John:
Goal 1: Enhance Psychological Flexibility
- Objective 1: Recognize and start accepting his anxious thoughts without the urge to escape them
- Objective 2:Implement mindfulness techniques twice daily
- Objective 3: Keep a diary documenting his capacity to recognize and manage anxiety symptoms in three specific scenarios, to be discussed in subsequent sessions.
Goal 2: Decrease Avoidance Behaviors
- Objective 1: Develop a values-based exposure hierarchy to gradually face anxiety-inducing situations
- Objective 2: Participate in at least one social activity each week of significance, noting his feelings before, during, and after to review together in sessions
- Objective 3: Reduce avoidance behaviors by 50% over the next eight weeks
Goal 3: Start Aligning Actions with Core Values
- Objective 1: Identify his core values concerning education and personal relationships
- Objective 2: Pinpoint 2-3 behaviors that reflect his core values and incorporate them into his weekly routine.
- Objective 3: Engage in actions that are consistent with his values to enhance his quality of life.
Specific Interventions to Be Used
Identify particular ACT interventions that are aimed at supporting John’s treatment aims and objectives. This can serve as a reference prior to future sessions to assist in selecting appropriate interventions.
Example for John:
Intervention 1
Introduce mindfulness practices designed to help manage anxiety symptoms effectively
Responsible Person: Counselor A
Intervention 2
Assign mindfulness exercises to encourage practice outside of sessions and monitor its usage
Responsible Person: Counselor A
Intervention 3
Apply cognitive defusion techniques
Responsible Person: Counselor A
Intervention 4
Develop commitment strategies that guide him in taking small, manageable steps to confront anxiety-inducing scenarios
Responsible Person: John
Intervention 5
Conduct values clarification exercises
Responsible Persons: Counselor A and John
Family Involvement
At this time, involving John’s family doesn’t seem urgent. However, it’s helpful to keep in mind the nature of John’s relationship with his parents as you move forward. If the situation shifts later and it becomes advantageous to include his parents in the treatment, adjustments can be made to the treatment plan.
Example for John:
Family Involvement: None currently
Additional Services and Interventions
Additional services can enhance John’s treatment experience. Many options may supplement ACT, including anxiety-specific group therapy, a psychiatric evaluation, and an ACT-based group. It’s crucial to offer only those services that won’t overwhelm him. Currently, a psychiatric evaluation would complement the initial stages of treatment well. Once John has adapted to his treatment schedule, consideration can be given to explore other beneficial services.
Example for John:
Additional Services: Psychiatric Assessment, Dr. Smith (123)456-7890
Estimation for Completion
Typically, an ACT treatment plan encompasses weekly individual or group sessions. The length of treatment varies according to individual needs, usually lasting between 12 and 16 sessions.
Example for John:
Estimated Time for Completion: 12 weeks of individual therapy sessions, adjustable as necessary.
Aftercare Plans
The aftercare plan section of your acceptance and commitment…
When creating a therapy treatment plan, it’s essential to include recommendations for your client in case of termination or early discharge. This may happen for various reasons, including scheduling conflicts or a dissatisfaction with the therapeutic relationship. Clearly outlining your suggestions in the treatment plan can help provide ongoing support to your client.
Example for John:
Aftercare Suggestions: Continue individual therapy with a local psychotherapist and consult with a primary care physician regarding changes in mental health treatment.
Concluding Thoughts on Developing a Treatment Plan for Acceptance and Commitment Therapy
We appreciate your interest in this guide on constructing an ACT Therapy treatment plan. Acceptance and Commitment Therapy proves effective for clients facing various anxiety symptoms and disorders. This method empowers clients to accept their thoughts while minimizing self-judgment, which can reduce their tendency to avoid situations and suppress feelings. Furthermore, ACT assists clients in aligning their actions with their values, potentially alleviating internal anxieties and enriching their lives.
Clients can continue to benefit from this approach by building greater emotional resilience and improving their capacity to manage distress. To further explore ACT and its therapeutic advantages, consider seeking continuing education and training opportunities within your professional field.
TherapyByPro is an online mental health directory designed to connect mental health professionals with clients seeking help. If you are a mental health practitioner, you can join our community and list your practice here. We offer assessments, practice documents, and worksheet templates that mental health practitioners can utilize to enhance their services. Check out all of our mental health worksheets here.
Explore all of our Acceptance and Commitment Therapy Worksheets
References:
- Acceptance and commitment therapy. ColumbiaDoctors. (2023, November 16).
- Sussex Publishers. (n.d.-a). Acceptance and commitment therapy. Psychology Today.
- The Six Core Processes of ACT | Association for Contextual Behavioral … (n.d.)
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