Introduction 1
1. Playing with the Choice Point 5
Introducing a very useful tool, the choice point, which we‘ll refer to throughout the book
2. Miserable Mindfulness 27
Misunderstandings and myths about mindfulness—for therapists and clients
3. Ghastly Goals 37
Problems related to establishing therapy goals
4. Beastly Barriers 59
Overcoming barriers to ACT, building rapport, and getting buy-in
5. Freaky Functional Analysis 73
The ABCs of functional analysis, and how this can enhance our therapy
6. Vicious Values 88
Values conflicts, rigid rules, “I don’t have any values,” and other common sticking points
7. Dodgy Dropping Anchor 114
The single most powerful intervention for extreme fusion
8. Crummy Creative Hopelessness 127
Mishaps and misconceptions about one of the most misunderstood parts of ACT
9. Dastardly Defusion 135
The myriad of ways that defusion can go wrong or backfire—and how to bounce back
Surprising Self-Compassion 165
The nuts and bolts of self-compassion
11. Sticky Structure 176
Confusion about and obstacles to process work in ACT
12. Measly Motivation 187
Homework horrors, “I’ve got no motivation,” and other barriers to committed action
13. Obnoxious Outcomes 196
Anything that can go wrong will go wrong—and how our responses make all the difference
14. Slippery Self-as-Context 201
Misunderstandings about self-as- context in therapists and clients
15. Exasperating Exposure 215
The nuts and bolts of ACT-style exposure
16. Awkward Acceptance 221
Problems and pitfalls pertaining to acceptance and willingness
Acknowledgments 226
Appendix 1: ACT Case Formulation Worksheet 227
Appendix 2: Informed Consent 230
Appendix 3: The Bull’s-Eye 233
Appendix 4: Defusion from Barriers to Therapy 235
Appendix 5: The Hands as Thoughts and Feelings Exercise 242
Appendix 6: Pushing Away Paper Exercise 245
Appendix 7: Triggers-Behavior-Payoffs
Worksheet 249
Appendix 8: Exposure Crib Sheet 250
Appendix 9: A Clinician’s Guide to Getting Unstuck from Just About Anything 251
References 258
Free Resources and Online Training 260
Index 262