Values: Clarity of Purpose, Crisis not Required

July was a heck of a month. Having just returned from a 5-month sabbatical, I was ready to get settled back into my life here in Portland when I got a phone call that stopped me in my tracks. We’ve all had those moments, when an unexpected event challenges us to consider what really matters, often with shocking, jarring clarity. Maybe it’s a phone call that a loved one is being rushed to the hospital. Or maybe it’s the day you lose your “dream job” or your physician gives you that unexpected diagnosis that will change the trajectory of your life. Or maybe it’s the moment your loved one looks into your eyes and says they are leaving you. These things can happen to any of us and if you’ve ever been confronted with one of these crises then I’m guessing it gave you pause to reflect.

Crisis and loss often have a way of clarifying what is most important to us. It often takes a crisis or significant loss to make us stop the autopilot of our lives and focus on what really matters. But what if it were possible to live with that kind of clarity of purpose and values without something terrible needing to happen? And what if your work could be about helping people do that?

At its heart, I think that’s what values work in ACT is all about. Living a values-based life is about living with intention, consciously choosing to live out a well-lived life, whatever that would mean for you personally. Values work in ACT is about creating a context where your clients are able to be connected with and live out their deepest values in a sustained and consistent way, not just when the crisis happens.

Our main tool in being able to help clients connect with what is most important to them (without the need for a crisis to shove that in their face!) is language. Although language often gets a bad rap in ACT, language is our ally when it comes to values work. Language and cognition are the very medium of meaning, purpose, and valuing, experiences which are central to what makes us human. Through various perspective taking exercises, for example, we can use language to enter into a remembered past or an imagined future to help us connect with what may be important to us in the grand scheme of things, beyond simply our immediate wants or preferences.

Over the next several months we’re going to be posting a series of pieces on this issue of values, how to have values guide your therapy and specific tools you can use to help your clients live with intention and clarity of purpose without the need for a preceding crisis. So if this is something you are interested in, stay tuned. Also, we’re currently working on a book on this topic called Values in Practice: A Clinician’s Guide to Helping Clients Develop Psychological Flexibility and Live a More Meaningful Life, to come out through New Harbinger Publications sometime next year. If you are interested in getting an announcement about when that will be released, feel free to send us an email and we’ll keep you posted about the publication date.

Jenna LeJeune, Ph.D

Author: Jenna LeJeune, Ph.D

Jenna is a clinical psychologist who specializes in working with people who struggle with relationship and intimacy difficulties and with those who have a trauma history. Her research focuses on developing compassion-based interventions targeting stigma, shame, and chronic self-criticism.

Interview with Jenna LeJeune, PhD on Values Work

I was recently interviewed for the Praxis blog about values work in ACT  in conjunction with the upcoming webinar I’ll be offering through Praxis called “Values: Connecting with Who and What is Most Important.” We covered a lot of ground in the interview, from how I might define values from an ACT perspective to looking at some of the most common difficulties therapists seem to have when working with clients around values.

One of the ways I think people struggle with values work is when we start talking about values as “things” or “words” that occur out there/then. In talking about the need to have values be present in the room when doing values work, I talked about the metaphor of the truffle dog I often use when talking about values work. As an ACT therapist, part of my job is to “sniff out” when values may be present, much like a truffle dog uses his nose to find the precious delicacies underneath the dirt and leaves. When the client and I are able to unearth a value that is present in the room, it comes alive and is something quite precious for both of us to behold and appreciate.

Below are some excerpts from the interview.

On the function of values clarification in psychotherapy:

From my perspective, values work gives you the “why” in treatment planning and in psychotherapy in general. Without getting clarity on a client’s chosen values, I can’t know what the hard work of therapy is in the service of. If I don’t know my client’s values, I can feel more like a technician, simply administering interventions in what can feel like a pretty impersonal manner. But when my client and I can get clear on what her own chosen values are, the work becomes personal, and in my experience, more vital.

On the ways that clients and clinicians get tripped up around values:

People playing the role of therapist often get tripped up around the same things that people playing the role of client do. In terms of values, one of the places where we can all tend to get tripped up, in my experience, comes when we start talking about values as “things.”

We (clients and therapists) can get caught up in trying to identify or choose specific value words. Exercises such as a values card sort, or selecting values from some predetermined list, while very helpful in the right context, in my experience can also lead to conversations that lack vitality, vulnerability, and a sense of being alive in the present moment.

On identifying instances when values work may be called for:

There are several different cues I look for that would lead me to focus more on values work in a session. Values and pain are two sides of the same coin, therefore, when clients are more numb, feel “empty”, apathetic, or otherwise are not in contact with the cost of the avoidance in their lives, it often signals to me that they are also not in contact with their values either. Focusing on values work in these cases can help the client come into contact with the discrepancy between what they are currently valuing by their behavior and what they would choose to value if they were free to do so.

I will also often turn to values work when it seems like the work of therapy is motivated by avoidance or aversive control. If a client is white-knuckling his way through exposure work or is engaged in therapy as a way to “fix” herself, I’ll often turn to values work to orient us to something we would want our work to move us towards.

You can read the entire interview here.

If you’re interested in learning more about incorporating values work into your sessions, you can sign up for the Praxis webinar  “Values: Connecting with Who and What is Most Important.”

Jenna LeJeune, Ph.D

Author: Jenna LeJeune, Ph.D

Jenna is a clinical psychologist who specializes in working with people who struggle with relationship and intimacy difficulties and with those who have a trauma history. Her research focuses on developing compassion-based interventions targeting stigma, shame, and chronic self-criticism.

Exposure Exercise Brainstorming Worksheet

Exposure Exercise Brainstorming Worksheet

Although it always seems easy enough when I read treatment manuals on exposure-based therapies, I’ve found in practice that it can be time consuming in session to come up with ideas for exposure-based exercises. Perhaps in part because exposure involves confronting uncomfortable experiences, even really motivated clients can have difficulty  coming up with suggestions on the spot. Moreover, most exposure manuals budget for 60-120 minute sessions, whereas a practicing therapist more frequently must make do with the 45-minutes permitted by insurance companies.

Recently, a light bulb went off: Why not simply ask clients to come up with ideas for exposure exercises outside of session? Worst case scenario is that they don’t do it, and we’re back to where we started. At the very least, the assignment primes clients to think about possible exposure exercises between sessions.

For this reason, I revised a fear hierarchy worksheet I had come up with for an online exposure training I completed last year.

Because I work from an Acceptance and Commitment Therapy (ACT) perspective, I call the worksheet: Valued Living Plan. It’s written in ACT language but could be used with other approaches.

In session, I describe exposure to clients, talk about the purpose and what makes a good exposure exercise, and give them the worksheet to complete between sessions. I’m still experimenting with it but am hoping it saves valuable in-session time for other things, such as in-session in vivo or imaginal exposure.

If it interests you, download a copy, and try it out. I’d love to hear your feedback!

UPCOMING TRAINING EVENTS