BBC Radio 4 - Acceptance and commitment therapy -feat Trudie Chalder Nov 2019

Sly Saint

Sly Saint

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Acceptance and commitment therapy; Million Minds tour; Personality traits and spending behaviour
All in the Mind
Acceptance and commitment therapy is an evolving talking therapy that is being used to address anxiety and depression. Rather than challenging negative thoughts, patients are trained to embrace them, Claudia Hammond hears how it's now being trialled for the psychological challenges that come with a number of physical conditions from muscular dystrophy to cancer.

We're at the culmination of the Million Minds tour - an attempt to reclaim the world record for the largest mental health lesson, which draws together psychologists, top performers and school children, aiming to break the teenage stigma surrounding mental health issues.

And with more financial transactions taking place online that ever before, can our digital footprint accurately reveal traits of our personality?
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https://www.bbc.co.uk/programmes/m000bmyf

not listened to this yet
 
Have listened to the bit with TC transcript below. She talks the usual twaddle.
TC:It’s called the third wave psychotherapy and people are getting really interested in it because it’s the next stage in that evolution of effective psychotherapies. And essentially it’s about accepting the things you can’t change, so things like symptoms, distress, unpleasant experiences that happen in your body or in your head. So it could also be unpleasant or unhelpful thoughts and thinking about how they interfere with your everyday functioning. And for many people, those things start to dominate their lives, and all of the things that they previously enjoyed and valued perhaps get affected. So the commitment therapy is about people identifying what they really value in life, and then acting according to their values.


Interviewer: and how is it different say from cognitive behavioural therapy, that some people might be familiar with? Where peoples thoughts about a certain thing are challenged. Is this about changing your thoughts or not?


TC: No. So that’s how it differs. So conventional CBT is all about challenging unhelpful thoughts and looking for alternatives. So it’s quite rational. Acceptance and commitment therapy is more about helping people to tolerate the discomfort, if you like, and the experiences that they are having that are impossible to control often, and then learning I suppose to tolerate them but live their value based life despite those experiences that they are having.


Int: and so they wouldn’t try to change the thoughts? They would just try to accept that those are there?


TC: yes and there’s a whole range of different ways of doing that. So, one way might be though learning some Mindfulness based techniques, another way would be thinking about life in metaphors but it’s really about the relationship you are having with those thoughts and feelings that we would be addressing.


……….


TC: all of the treatment was carried out by one highly qualified and highly skilled clinical psychologist. I can’t give you the precise results at the moment but I would just say that the reports that we have had from patients in our interviews has been that it has been very helpful.


Int: In one way is it a less optimistic approach than some other therapies because it is saying you’ve got to accept it how it is? And things won’t change and get better.


TC: Actually no, I think the opposite. I would say that it is a very optimistic way of looking at the world because although there are some things that you can’t change directly, there are lots that you can do make your life more fulfilling.


Int: Do you know yet what it is about ACT that might be working, what’s the mechanism that’s causing some change and making people feel better somehow.


TC: Yes, I think that’s the multi million dollar question. I think what is purported to be the mechanism or change is flexibility. SO people become more flexible, in response to the experiences that they are having.

So it then means that they can choose how they move forward with their lives and that they are not then stuck with one particular response that they may have used previously.


Int; and have you been impressed with what you’ve seen in people you’ve worked with?


TC: Yeah I have. And often when you offer people that kind of explanation they go ‘ooh yes, that seems to make sense’, if you say well has what you’ve done thus far over the last two years in terms of trying to control these symptoms , has it worked? They’ll often say well no it hasn’t so therefore I’d like to look at it differently. So I think asking the question whether what they have done previously has worked often leaves them to think well maybe I need to adopt a slightly different relationship to my experiences.
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Interesting that she mentions the research of ACT with muscular dystrophy
I can’t give you the precise results at the moment but I would just say that the reports that we have had from patients in our interviews has been that it has been very helpful.
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proving that you don't have to 'have looked at the data' [before any potential change in protocol, outcome switching etc] to know how the results might stack up.
 
This reads to me like a confession that she has worked for many years on CBT and that was useless so they'll try something else, but really they are fumbling in the dark and haven't a clue what they are doing, but so long as they can persuade some of their clients to tell them they are helpful, that's OK.

Doesn't she realise whatever you do, if you do it with some semblance of knowing what you are doing and listening to patients, they will want to please the therapist and want to show they are trying hard to do what they are told, so of course some of them will say it's helpful.

And you get made a professor for being this useless...
 
I agree with @Trish and @Diluted-biscuit.

It is likely that once a relationship is established, people don't want to really rock the boat. Especially in an unequal relationship: patient - therapist. One's disability eligibility may count on this as well. The patient will say, "Yes, this therapy really helped" or some such similar comment. And, just being able to talk about problems can be helpful - someone paying attention.

Nice work - to not be sure how the therapy works, but get to roll it out anyways.

Acceptance of things we cannot change is an old concept - not outmoded, but is used in other fields like addiction/Alcoholics Anonymous. ACT seems to be a re-bottling of this older concept previously developed by others.

"Always look on the bright side of life!"

ETA: removed the word "your"
 
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Patients want to believe there is a way to get better. What easier way to get better than just thinking differently?

So patients and therapists reinforce each other's unrealistic hope that some mind trick can cure a horrible illness.
 
Trish said:
This reads to me like a confession that she has worked for many years on CBT and that was useless so they'll try something else, but really they are fumbling in the dark and haven't a clue what they are doing, but so long as they can persuade some of their clients to tell them they are helpful, that's OK.

Doesn't she realise whatever you do, if you do it with some semblance of knowing what you are doing and listening to patients, they will want to please the therapist and want to show they are trying hard to do what they are told, so of course some of them will say it's helpful.

And you get made a professor for being this useless...
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I particularly like how the description of ACT is basically the exact opposite of CBT, accepting vs challenging thoughts, and yet provides the exact same benefits.

Doing two mutually exclusive things and expecting the same outcome of "helpful" feelings, no numbers, just feelings. Hmmm... yes. "Science"

Also:
all of the treatment was carried out by one highly qualified and highly skilled clinical psychologist. I can’t give you the precise results at the moment but I would just say that the reports that we have had from patients in our interviews has been that it has been very helpful.
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Bartenders have been providing this exact "this has been helpful" thing for millennia. Not even much need for being "highly qualified and skilled". I mean that literally, bartenders have long carried this exact same role, being merely "helpful" and probably doing it cheaper as well.

Giving $5 is helpful to ending world hunger, if we use that definition. Almost anything counts as that if we only go with feelings. The recent "sunbathe your taint" has pretty much been hailed as helpful as well. No numbers there either, it just "feels" right.

Must be hard to have built one's career on blatant pseudoscience and finding themselves painted in a corner but it's definitely not going to look good with hindsight to continue doing so despite always having to resort to "well, some people feel that it's good", which gurus of all types have also been doing for decades. Might as well swing a magic healing jacket while they're at it, same idea.
 
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