Therapeutic Approaches & Frameworks

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that focuses on helping individuals accept their thoughts and feelings while committing to actions that align with their values. Here are the first steps typically involved in practicing ACT:

1. Establishing rapport: The therapist builds a trusting and supportive relationship with the client. This involves creating a safe space for the client to share their experiences and emotions without judgment.

2. Clarifying values: The therapist helps the client identify their deeply held values and what truly matters to them in life. This step involves exploring different life domains such as relationships, work, personal growth, health, and spirituality.

3. Mindfulness training: Mindfulness is a fundamental aspect of ACT. The therapist introduces mindfulness exercises to help the client become aware of their thoughts, emotions, bodily sensations, and the present moment. Mindfulness techniques may include breath awareness, body scans, or observing thoughts without judgment.

4. Identifying cognitive fusion: Cognitive fusion refers to the tendency to get entangled with thoughts and treat them as absolute truths. The therapist assists the client in recognizing instances of cognitive fusion and understanding that thoughts are not facts, but rather mental events that can be observed.

5. Observing and accepting emotions: The client learns to observe their emotions without attempting to control or avoid them. The therapist encourages the client to accept and make space for uncomfortable emotions, acknowledging that they are a natural part of human experience.

6. Defusion techniques: Defusion techniques help the client distance themselves from their thoughts and reduce their impact. The therapist introduces exercises such as labeling thoughts, using metaphors, or singing thoughts out loud to demonstrate that thoughts are separate from one's core self.

7. Values-based goal setting: The client identifies specific goals or actions that align with their values. The therapist assists in breaking down these goals into manageable steps and encourages commitment to taking action towards them.

8. Committed action: The final step involves implementing the values-based goals in daily life. The therapist supports the client in overcoming barriers and challenges that may arise, fostering a sense of accountability and perseverance.

It's important to note that ACT is a highly individualized therapy, and the specific steps may vary depending on the client's unique needs and circumstances. The above outline provides a general framework for understanding the initial stages of ACT.

What is trauma-informed psychotherapy?

Allow me to start with a few definitions; not for the sake of being boring or establishing some supposed academic superiority. No, not at all; rather to simply to set the scene and create a mutual base of understanding from which to move forward.

“Trauma” originates from the Greek word for wound. In the field of psychology, quite often a distinction can be made between what I like to call lower-case trauma or Trauma with a capital T. All people experience traumatic events along their lives’ journeys that most certainly are impactful and marked but are not necessarily considers a capital T Trauma. The later is an experience or series of happenings that expose the individual to actual or thread of death, serious harm and physical or sexual injury or violence. Not wishing to negate the seriousness and challenging nature of lower-case trauma, these are extremely difficult and significant life events. Some examples may include divorce, a miscarriage or severe illness.

“Psyche” is the Latin word for soul. Not necessarily soul in the religious, spiritual sense but in the sense of one’s mind. Mind, that certain type of awareness within a person that enables them to be aware of the world and their experiences, to think, and to feel; the faculty of consciousness and thought, their ability to reason, in the context of her knowledge, memory and insight.

The term one’s mind, much as the term soul denotes something rather intangible yet consistently present. Something not readily located within our physical body. Yet it is produced by a part of our anatomy, controlled by our brain. Colloquially we often use mind and brain interchangeably. Yet the mind is something mental that cannot be touched, made by the physical brain. Our brain which is “nothing more” than neuro chemical processes within its tissues composed to blood vessels, nerve cells, protein, carbohydrates, salts, fat and water.

Our other organs like the heart, stomach, liver, our lungs and kidneys, and so on, all are made of similar buildings blocks and they each regulating their function with the help of just that brain. The brain and the other organs work together to create a constant internal environment, that is stable and balanced for the optimal functioning of the human organism, a function we call homeostasis. 

Yet, when it comes to the brain and its function of creating mind, it cannot regulate itself alone. Our mind has an inherent social function and thus our brain requires the interaction with others in the outside world to achieve optimal function.  From our first living moments our brain commences to absorbe the influences from the outside world that allows us to feel either safe and nurtured or unsafe and thus ready to run or fight for our survival.

Enough already, what does all of this have to do with my current challenges and why is and understanding of my past so important to help me improve by coping for now and into the future?

When our brain has been exposed to many, or maybe too many, traumatic events or even significant Trauma, it processes these as lessons in survival and thus creates a mind-set ready and primed to protect its human vessel. In this way our past influences us today as our mind impact our thinking, our coping, our behaviours and also sometimes our ability to engage in healing and treatment.

Trauma-informed psychotherapy acts from an assumption that a client may have experienced t/Trauma and thus aims to gently aid in the exploration of the client mind without risking re-traumatisation and carefully holds the space for safe processing and recovery by utilising the interactions with the therapist to allow the mind to obtain a new improved equilibrium.

In this way trauma-informed therapy adheres to the following five principles to set a secure framework for client and therapist to navigate within:

1. Safety – Both physical and emotional are primarily addressed and are the utmost important step in the provision in trauma-informed therapy.

2. Choice – At all times it is through informed consent that the client has the choice to proceed and remain in control.

3. Trustworthiness – The therapist must take measures to ensure the individual understands them to be trustworthy. This is created through clarity and consistency in the acceptance of interpersonal boundaries and respect.

4. Collaboration – With safe choices and trustworthiness established the individual is free to effectively collaborate in their therapeutic journey, making them more likely to invest themselves and have better outcomes.

5. Empowerment – In this way trauma-informed therapy provides and environment that allows the client to feel validated and affirmed which results in skill building and empowerment beyond the treatment.  

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