Values conflicts? Is that a thing?

I love values. People tend to know that about me and so I often get presented with values questions from colleagues or friends. And one of the most common questions that seems to come up has to do with what to do with supposed values conflicts.

While I usually try to approach these questions with openness and curiosity, I’m going to be totally honest here. These questions about “values conflicts” confuse me. It’s like the feeling I had once when I saw an advertisement for a medication to help with the “problem” of “inadequate” eyelashes (true story!). My response was, “Wait, that’s a problem? I didn’t know that was a thing to worry about? Maybe I have that problem and don’t know it!?!” This is how I feel about values conflicts.

Values conflicts just really aren’t something that come up for me in my work or in my life. While I’d love to say that this is because I’m some values Yoda and I’ve got it all figured out, I am 100% certain that is NOT the case. And yet, I keep hearing over and over, on listservs, in supervision, in consult groups about these “values conflicts” that people are struggling to know how to deal with. Am I missing something?

Then, I was recently sitting in a workshop on values at the most recent ACBS World Conference in Montreal and it struck me– the problem is one of terminology. When people are talking about values conflicts they are usually talking about conflicts between values domains NOT conflicts between what I typically mean when I use the word “values.” Basically, they are dealing with what I would call time management problems between various valued domains. These are often struggles a person is experiencing as they try to find balance between various areas of their life that they value that have competing needs, such as their professional life and their family life. This often gets translated as a conflict between one’s work-related values and one’s family-related values. But I would maintain that it’s more workable to approach this as a time management conflict rather than a values conflict.

From an ACT perspective, we stand in the place that valued living is always immediately available to us. That means, that regardless of circumstance, I can always choose to live a life that is in accordance with my values. At any moment, in any context, I am able to choose actions that help move me in direction of my values. Saying that valued living in one domain is in conflict with or is incompatible with valued living in another domain seems to go against this whole notion that I can ALWAYS be living out my values. From this perspective, there are no circumstances that stand in the way of me or anyone else getting to be the person they most want to be (i.e. live in line with their values). That’s why I don’t think it’s useful to approach these difficulties as “values conflicts.”

There are, of course, competing life demands. Most people have to spend significant portions of their day at a job, for example. And putting time or resources into one domain likely does mean you are not putting that time into another domain. When I am at work seeing clients, I am not at home caring well for my family. When I am at the gym attending to my health, I cannot simultaneously also be spending that time attending a community garbage pick-up event. So I would maintain that there are of course time conflicts and we may need to work with our clients (or ourselves!) around things like work-life balance. But posing these as values conflicts does not seem to me to be a workable position to take.

If the aim is to live a life that is guided by values, then it may be more useful to address these struggles is to look at the values congruence across the domains, rather than approaching them as a conflict between competing values. For example, when it comes down to your core values, what is most dear to you, is the person you want to be with your friends and family really incompatible with the person you want to be with your colleagues and clients? I’m guessing not. Sure, I act somewhat different at work than I do with my family, but in both cases some of my core values are things like compassionately caring for others and being warm and kind in my relationships. By focusing on the values congruence across domains I am able to simultaneously be moving towards being the warm and loving person I want to be to my partner even while I am being that warm and loving person to my clients. I am simply being more of the Jenna I want to be across all areas of my life regardless of whether I am at work or home or at the gym. Conflict resolved! Now if I could just clone myself so I could be in more places at once, then that would take care of the whole time management issue.

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.

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


Acceptance & Commitment Therapy – An Experiential & Practical Introduction

Jason Luoma, PhD and Jenna LeJeune, PhD
November 13th and 14th, 2021 from 8:30am-4:30pm
at Hilton Garden Inn Portland Airport
This two-day in-person workshop provides a thorough overview of the theory, principles, and techniques of Acceptance and Commitment Therapy. It is intended for those who are relatively new to ACT and for those who have done some reading on their own about ACT but who may not have had the opportunity to participate in more experiential learning, observe models, or receive feedback while using the ACT model. Read More.


Ethical & Legal Considerations in Psychedelic Integration Therapy

Brian Pilecki, PhD and Jason Luoma, PhD
November 19th, 2021 from 9am-11am

There is an increasing demand from clients seeking therapeutic support in their personal use of psychedelics. However, many clinicians interested in psychedelic preparation and integration are unsure as to how to provide these services as psychedelics mostly remain illegal. In this workshop, we will outline legal and ethical frameworks relevant to providing therapy to clients around their personal use of psychedelics, as well as describe how harm reduction approaches are suitable for this developing clinical area. Read More.


De-Mystifying Self-As-Context in ACT: Practical Strategies for Clients

Brian Pilecki, PhD and Kati Lear, PhD
December 3rd, 2021 from 12pm-1:30pm

This workshop will outline how self-as-context can be used to conceptualize commonly discussed topics in therapy such as self-esteem, confidence, identity, and inner conflict. Participants will learn how to flexibly practice practical self-as-context interventions that can be used with clients, as well as have a chance to practice newly learned skills through structured role-play exercises in breakout groups. Read More.


Values in Therapy: An Intro to Working with Values from an ACT Perspective

Jenna LeJeune, PhD
January 21, 2022 from 12pm-2:00pm

This workshop will provide a theoretical and conceptual overview of values from a contextual behavioral science perspective. We will cover the “what”, “why”, “when”, and “how” of values within ACT. While we will also provide an overview of various values exercises and measures that can be used with clients, the emphasis in this workshop will be on providing a foundational framework that will help clinicians approach values work from a functional perspective rather than a primarily technique-focused approach. Read More.



Culturally Responsive Therapy: How to Apply Anti-Racist Values in Session

Christy Tadros, LPCC and RaQuel Neal, LCSW
February 4th, 2022 from 1:30pm-4:45pm
and February 5th from 9:00am-12:00pm

This 2 day 6-hour training will help therapists develop their ability to support clients from a different racial background than them, with a particular focus on Black, Indigenous and People of Color. Through a multicultural social justice framework, it will integrate research and clinical experience to teach a therapeutic model for rapport building, assessment, and treatment. This model is not a rigid therapeutic modality, but provides a contextual lens to build a strong, culturally grounded therapeutic relationship. It is a flexible model and can align with many therapeutic modalities, including a contextual behavioral approach to therapy. Read More.


Truffle Hunting: Bringing Values to Life in the Therapy Room

Jenna LeJeune, PhD
February 25, 2022 from 12pm-2:00pm

This brief workshop is designed to help clinicians deepen their values work with clients by shifting the focus from the content of values conversations to the quality of those conversation. By listening for and deepening the qualities of effective values conversations participants will get a taste for how more experiential and relationally-based values work can supercharge therapy. Participants will have opportunities to both observe demonstrations and practice in small groups with the benefit of feedback. Read More.


Values Prototyping: Using Action to Help Clients Explore Their Values

Jenna LeJeune, PhD
March 18, 2022 from 12pm-2:00pm

This workshop will focus on one specific experiential tool called “values prototyping” that helps clients learn more about their values through engaging in intentional valuing. As participants will hopefully already have a solid foundation of some of the core concepts of the values process in ACT, this workshop will dive right in on how to use values prototyping to help clients learn more about what they would choose to value in their life. You will have the chance to practice developing a values prototype in small groups with the benefit of feedback, so that by the end of the workshop you will be able to use this tool in your work with clients. Read More.


The Invitation to Change Approach: Helping Families Affected by Addiction

Jeff Foote, PhD and Cordelia Kraus, LPC, CADC 1, certified CRAFT clinician
May 13th and 14th, 2022 from 9:00am-5:00pm
at University of Portland, Terrace Room
This two-day in-person workshop will provide skills training for professionals focused on the process of working with clients who have a loved one struggling with substance use issues. The Invitation to Change Approach draws on CRAFT (Community Reinforcement and Family Training), MI (Motivational Interviewing), and ACT (Acceptance and Commitment Therapy) to provide a compassionate and collaborative way of working with the families and concerned significant others of people who struggle with substance use. Read More.


Therapy and Research in Psychedelic Science (TRIPS) Seminar Series

Second Friday of each month from 12:00 PM – 1:00 PM (PT)

TRIPS is an online seminar series that hosts speakers discussing science-informed presentations and discussions about psychedelics to educate healthcare professionals. This series was created to guide healthcare providers and students preparing to be professionals towards the most relevant, pragmatic, and essential information about psychedelic-assisted therapy, changing legal statuses, and harm reduction approaches in order to better serve clients and communities. This seminar series is a fundraiser for our clinical trial of MDMA-assisted psychotherapy for social anxiety disorder that Portland Psychotherapy investigators are preparing for and starting in the Fall of 2021. All proceeds after presenter remuneration will go to fund this clinical trial. Read more.

November 12th, 2021Psychedelic Research: Implications for Palliative Care and End-of-Life Existential Distress with Anthony Bossis, Ph.D.

December 10th, 2021Implementing Culturally-Attuned & Anti-Racist Psychedelic Therapy: Impact over Intention with Jamilah R. George, M.Div., M.S.

January 14th, 2022Psilocybin-Assisted Therapy of Major Depressive Disorder using Acceptance and Commitment Therapy as a Therapeutic Frame with Jordan Sloshower, MD, MSc

February 11th, 2022 – Drug-Drug Interactions Between Psychiatric Medications and MDMA or Psilocybin with Aryan Sarparast, MD