Doing ACT with Teens: Using Values to Promote Real Behavior Change

Values clarification is a critical part of any psychotherapy session. It may be more challenging for some teens than others, to get in touch with what matters to them. For those who struggle, clinical psychologist Sheri Turrell, PhD, and social worker Mary Bell, MSW, suggest a number of options.

Louise Hayes’ Values Cards, which are included in her book The Thriving Adolescent, make a fantastic tool for exploring values by encouraging conversation and discovery around what matters to adolescents. Russ Harris’ Values Identification Form, which was adapted from Kelly Wilson’s Valued Living Questionnaire, can also be easily adapted for values work with teens.

If you’re familiar with the matrix tool, you can introduce the concept of values by asking teens to look at what they’ve placed on the right side of their diagrams; the qualities in themselves that are important and the people in their lives who matter.

If you’re not using the matrix tool, you can still describe values by pointing to visible actions that will occur when their values are directing their behavior, and they are treating those who matter as if they are important.

In their new book, ACT for Adolescents: Treating Teens and Adolescents in Individual and Group Therapy, Turrell and Bell suggest asking the following questions:

Is there a part of your life that you really want to put some attention into, where things don’t feel fulfilling?

Are there people in your life who are important to you, who matter, but your relationships doesn’t feel good in terms of who you are in that relationship?

If I had the people who matter to you in my office, and I asked them what they liked or loved about you, what would you hope they would tell me?

What would be the qualities you hope the people who are important to you would point out because they are qualities that matter to you?

Of all the qualities you just identified, which ones would still be important to you if no one actually noticed them?

If we had people who matter at your graduation party, and they were giving speeches about you, what would you hope they would say about you?

Can you remember a time when you did something that made them feel anxious, fear, or other unpleasant emotions? Why did you choose to do it inspire of your discomfort?

Common Traps

There are a few common places clinicians tend to get stuck in the values clarification process with teens. The following have been adapted from Turrell and Bell’s book.

Mistaking rules for values

During the initial values clarification process, it’s important to make the distinction between rules and values. Rules can sometimes mimic values, but they inhibit psychological flexibility by creating behaviors that are rule-driven instead of values-driven.

If your client says things like, “I have to be _____ or else _____ will happen,” she’s likely mistaking rules for values. Lots of teens experience the fear that if they don’t act a certain way they will be rejected. If living according to an inner quality is mostly about that quality being noticed by others in order to maintain connection and avoid rejection, that’s a sign that the quality may not actually be a value.

Mistaking goals for values

Imagine that a client says “being happy” is a value. Remind her about the illusion of control and ask whether being happy, or having any particular feeling at all, is really something that is hers to control. When she answers no, you can use the opportunity to ask, “If you were happy, what would you be doing?” This will lead both of you closer to identifying her values.

Or, let’s say a client says “being successful” is a value. Again, you might ask, “If you were successful, what would you do with your life, what would matter to you?”

Overemphasis on what others want or think

When identifying their values, it’s common for teens to veer toward things they want other people to think or feel. A client may say things like “I want my parents to be proud of me,” or “I want others to think I’m fun.” Follow up these statements by getting back to the illusion of control mentioned above.

Ask, “How easy is it to control how you feel, or how someone else feels?” When they’ve determined for themselves that these things are in fact out of their control, remind them that they do have control over how they live their day and the qualities they bring to their lives. 

Mistaking personal values for other people’s values

Teens may say they value things like “being organized” or “being less distracted,” which are often times reflections of things their parents and teachers have told them throughout their lives. When you inquire further into why these are important to a client, keep your ears open for “shoulds.” These will alert you to the possibility that what she thinks are her personal values are in fact rules that belong to other people. These will not bring her closer to moving toward truly values-driven behavior.

For more about helping teens get in touch with what matters to them, check out ACT for Adolescents

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