Most cognitive behavioral therapy approaches focus on aversive symptoms and problematic behaviors. This emphasis can limit the attention that’s paid to experiences that focus on growth and prosperity, such as a client’s culture and faith. Acceptance and commitment therapy, however, has a marked focus on values-based living, which aims to increase functionality by using values as a compass to do so.
When clients get in touch with difficult emotions in session, crying is a normative behavioral reaction. At times, a client’s level of emotional distress may appear to escalate to an out-of-control level.
Notice your reaction to the client’s emotion, even the thought that it is out of control. If you want to control your client’s emotions, notice this urge and reorient to being with the client in that moment, sitting with him or her compassionately.
Functional analytic psychotherapy (FAP) focuses largely on the therapeutic relationship and the interpersonal behaviors that occur in sessions. FAP therapists pay special attention to identifying clinical relevant behaviors — behaviors that take place in sessions and exemplify the client’s real-life problematic behavior (termed CRB1), and the client’s real-life improved behavior (termed CRB2). These are the “away moves” and “toward moves” clients engage in during sessions.
The goal of psychotherapy should be to increase a client’s psychological flexibility. When it comes to clients with emotion regulation disorders, research shows that experiential avoidance and distress intolerance are the two transdiagnostic factors that are responsible for much of the inflexibility that they experience.
Behavior change that is consistent with personal values is the purpose of psychotherapy. As teens begin to identify what’s important to them and take steps to behave in ways that move toward those things, they will experience internal events that may be intense or challenging. These are things they’ve spent energy avoiding in the past, which have in turn steered them further away from their values.
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.
Everybody worries, but some people have more than their share. Their peace of mind is often disrupted by “what if?” thoughts of bad possibilities. They recognize that worries are repetitive and unrealistic, but when they try to stop worrying, it gets worse rather than better!
Hearing traumatic material from clients is tough work and can result in what the literature has termed vicarious traumatization of therapists. That is, the therapist can be traumatized by hearing a client’s story and absorb their pain. Therapists are human, and because we care, it hurts to hear another human’s pain. This is part of why we are effective helpers. However, it is crucial to have strategies for coping with our own pain and holding a client’s pain without feeling traumatized, so we can be effective helpers.
Our clients have rich and meaningful life stories. Some are painful and are directly related to why they are seeking therapy. Life stories may involve a current crisis or a core narrative about a client’s life, such as being a victim or helpless. It is important to acknowledge these stories with compassion.
However, these same stories can also serve to keep clients stuck.