Acceptance and Commitment Therapy is a broadly applicable approach because it is focused on psychological flexibility processes that undergird the interaction between human cognition and direct learning processes. The psychological flexibility model affords a unified approach to contextual CBT methods more generally, but only if practitioners understand how these processes work, can read them in flight, and target them creatively and effectively. At that point, a different kind of evidence-based practice is possible: one that fits knowledge about processes and procedures to clinical needs rather than applying named packages. In accord with the theme of this year's convention, dissemination of broadly applicable processes is far more practical than dissemination of myriad narrowly focused packages - and it is a lot more fun to practice that way.

This workshop assumes that attendees know core ACT methods reasonably well, know the "hexaflex" psychological flexibility model, and have done ACT work with patients. We will alternate between advanced ideas and advanced methods, always returning to how to understand and read processes, and how to be creative in applying and inventing techniques to move these processes. We will focus on such issues as how to think of psychological flexibility evolution science terms; how to read bodily cues and how to use your body inside a psychological flexibility model; how to create powerful clinical metaphors on the spot; how to use deictic framing in the advancement of perspective taking; creating physical metaphors that last; dong exposure from an ACT point of view; and how to dance among the response styles of being open, aware, and engaged.

You will learn:
1. How to think of the psychological flexibility model from an evolutionary perspective
2. How to read psychological flexibility processes in the moment
3. How to sequence methods in a way that maximizes movement by applying the psychological flexibility perspective
4. How to be creative technologically while still being evidence based at the level of process and procedure

Recommended readings (optional):

Hayes, S. C., Strosahl, K. & Wilson, K. G. (2011). Acceptance and Commitment Therapy: Psychological flexibility as a united model of human growth and behavior change (2nd ed). New York: Guilford Press. [This second edition of the main ACT book should be out by ACBT. A lot of it is new and it fits the spirit of this workshop]

Luoma, J., Hayes, S. C. & Walser, R. (2007). Learning ACT. Oakland, CA: New Harbinger. [A step by step learning companion. Very practical and helpful. Includes a DVD to help read flexibility processes]

Exposure procedures, both formal and informal, are one of the core problem-solving strategies in Dialectical Behavior Therapy (DBT). Indeed, the DBT manual specifically recommends the use of exposure to treat certain problems such as co-occurring anxiety disorders, which are present in approximately 80% of clients with borderline personality disorder (BPD). However, exposure procedures are often underutilized in DBT and, as a result, the remission rates for anxiety disorders among severe BPD clients in DBT are relatively low (< 50%). This workshop will present an overview of the use of both informal and formal exposure procedures during DBT with severe and multi-problem BPD clients. Participants will also learn when and how to integrate formal exposure protocols into DBT to treat co-occurring anxiety disorders. Throughout this training, particular attention will be paid to managing suicidal behaviors as well as other common problems that may arise when implementing exposure procedures with this complex client population.

You will learn:

1. How formal and informal exposure procedures are used in DBT
2. The principles to consider in determining when to use exposure in DBT
3. How to identify and troubleshoot common problems that occur during exposure

Recommended readings (optional):

Linehan, M.M. (1993a). Cognitive-behavioral therapy for borderline personality

disorder. New York: Guilford Press.

Harned, M.S. & Linehan, M.M. (2008). Integrating Dialectical Behavior Therapy and Prolonged Exposure to treat co-occurring borderline personality disorder and PTSD: Two case studies. Cognitive and Behavioral Practice, 15(3), 263-276.