Adding Values
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We're running some out-patient based Behavioural Activation Groups for clients with low mood/depression, using Martell et al's (2004) Overcoming Depression One Step at a Time. We're gradually increasing the time spent on values, so we now spend at least whole session on the topic, that seemed to really resonate with the group and gave a much better context for the identification of meaningful activity, and helping make strategic changes.
This deviates from the structure of the self-help book, but seems to add value (pun intended) to the whole approach.
Any thoughts/comments?
Joe
behavioral activation
The question ought not to be whether ACT components are compatable with BA (certainly in the broader sense the underlying principles are similar), but whether adding another component such as values work or even the use of metaphors etc. adds anything of clinical significance to working with the client. If the same outcomes are able to be achieved with standard BA why add extra components?
Values and BA
We presented some data on our Behavioural Activation groups at the UK BABCP conference last week (July 2008), with Chris Martell in the audience (and L-G Ost and Ronald Rapee - so no pressure there).
Chris Martell led the discussion - during which the point was raised about the whether the addition of values work and an 'acceptance' session (to provide an alternative to control) made our version of BA more ACT than BA. It was interesting to conceptualise these components from a broad functional contextual perspective, as we noted that values help provide the context for what types of activities will function as positive reinforcers. We also examined the function of acceptance as at least disrupting the patterns of negative reinforcement and subsequent narrowing of behavioural repertoire that people get into in the struggle with their symptoms.
In my view these two ACT components, and committed action, are the most compatible, but crucial differences between BA and ACT remain, particularly as ACT has a more detailed account of cognition.
Values in BA: a case of using augmentals?
Yes, I would agree that adding values work does seem consistent with the BA approach, and also links with functional contextualistic underpinning of BA and ACT, especially if we are considering the literature about rule governance.
I am wondering whether it is "wrong" to add ACT components to the BA approach, if, in essence, these components are theoretically/philosophically from a similar place, and you are clear about the reasons why you would make additions?
It seems to me that principle-based contextual therapies like BA and ACT can share components, but I wonder what other people think of "mash-ups" like this?
I note that Kanter and colleagues have recently described adding a FAP stance to BA to make it [even]more behavioural....
Workability and Context
Hey Joe, Eric
Well 2 things come to my mind - workability and context.
If you've found that clients "take to it" Joe and it opens up their life increasing vitality and opportunities then is that in itself the criterion to consider most of all??
The second thing is context - I am mindful of the ACT components of
self as context and present moment - I have seen it proposed that these 2 processes can be seen as "vantage points" from which to view the other processes of defusion, willingness etc.
Can this be proposed here?
Values being a "context" to view and perhaps enhance the BA principles - I use the terms lightly here.
I am increasingly aware of the role of values in my work, i do something similar to that which you describe Joe, and yes the clients really appreciate the "texture" it adds, I hear comments like, "it makes sense of what I am doing."
Lastly I would conjecture that if one views "Values" as more of an action rather than a moral or an exclusively cognitive process Values , as in what I do are my Values seems consistent with BA to me.
Again I am holding these terms lightly.
Love & Light
Martin