| 1 | Session 1 |
Introduction to the ACT programme and programme overview. Review of treatment history and evaluate it in terms of how it has worked relative to the participant’s goals and expectations. Review the interactions between thoughts, feelings and function, which often serve to make each other worse (eg, become a ‘vicious cycle’). Introduce the idea that change is possible - not based on symptom reduction but on aiming to alter function. Introduction to mindfulness technique. Homework assignment: check in with self daily and focus on activities.
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| 2 | Session 2 |
Introduction to the concept of acceptance and how one’s experience of their symptoms from their various conditions may limit participation in valued activities. Explanation of values. Mindfulness explanation and debrief. Homework assignment: Mindfulness practice daily.
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| 3 | Session 3 |
Identification and clarification of values. Assessment and rating of values. Discrepancy between values and current function. Leave on a stream mindfulness exercise. Mindfulness debrief. Homework assignment: Mindfulness practice daily.
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| 4 | Session 4 |
Barriers to pursuing values. Overcoming barriers. Swamp metaphor—exercise exploring the possibility for values-based action even with aversive experiences. Discussion on the concept of willingness and unwillingness to have discomfort. Body scan mindfulness exercise.
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| 5 | Session 5 |
Goal setting exercise in line with three chosen values. Discussion on fluctuating levels of high and low functioning and benefits of activity pacing in order to achieve a more consistent level of activity from day to day. Homework assignment: Record performance over the next week regarding carrying out specific actions and pacing of activities and practice mindfulness every day.
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| 6 | Session 6 |
‘Tricks of the mind’ exercises to raise awareness of language-based influences on function. Cognitive defusion exercises—finding a place to sit metaphor, get off your butts exercise, milk exercise, passengers on a bus exercise and ‘buying’ thoughts. Homework assignment: practice mindfulness and cognitive defusion techniques daily.
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| 7 | Session 7 |
Planning and action. Willingness and committing to action. Mindful walking exercise. Homework assignment: commit yourself to action.
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| 8 | Session 8 |
Emphasis on commitment to actions and values even when barriers exist and future planning - this is a ‘lifelong assignment’. Preparation for relapses and setbacks. End of programme. Recap on topics covered throughout the programme.
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