ACT for Social Anxiety – A Great Self-Help Book and Treasure Trove of Resources

ACT for Social Anxiety – A Great Self-Help Book and Treasure Trove of Resources

I’ll make a confession here: I’m a failure at bibliotherapy. By bibliotherapy, I mean assigning a self-help book to a client and following it along with the client in order to guide treatment. For clients who are interested in self-help resources, I’ll make recommendations for books that clients can read on their own as a complement to treatment, but I feel stifled at the idea of using the book to guide treatment.

The authors of Mindfulness and Acceptance Workbook for Social Anxiety & Shyness have made things much easier for therapists like me. The book is based on a group treatment for social anxiety that has been studied in two published research studies—an initial pilot followed by a randomized controlled trial.

On their website (www.actonsocialanxiety.com), the authors offer a downloadable treatment manual based on their book. The manual is an adaption of the group treatment manual they (Jan Fleming, MD and Nancy Kocovski, PhD) used in their research studies. It includes copies of the handouts, so you don’t have to press your book against the photocopier—which I find a bit of pain to do in the digital age.

If you visit the publisher page on the New Harbinger website and register, you can also download audio files of the exercises (e.g., mindfulness exercises) and a separate collection of the handouts.

I’ve not had a chance to use the book in therapy yet, but I’ve read through it and am very impressed with it. The book is engagingly written, includes interesting exercises, and is relatively concise (I prefer brevity in a self-help book).

For all these reasons, I highly recommend Mindfulness and Acceptance Workbook for Social Anxiety & Shyness. You can find additional resources at the authors’ website and on the publisher’s website (under the “Accessories” tab—but you must register). Check it out—it’s one of the better self-help books I’ve read and the resources the authors provide are extremely generous.

Top 5 Mindfulness Resources

Top 5 Mindfulness Resources

The science of mindfulness is a very hot topic these days.  In agreement with the research, we find mindfulness to be a very helpful skill to have that is effective for a variety of problems that come with everyday life, such as distractibility, emotional reactivity, and impulsive decision making.

If you’d like to learn this skill, we have one one simple piece of advice – practice!  Any skill that you want to get better at (gardening, sports, playing an instrument) requires practice, and plenty of it.

In order to help you to learn how to train your mind in this way, we’ve put together a list of our top 5 resources for learning mindfulness. Some of these applications and websites are also helpful for providing a sense of community around mindfulness, which helps with both accountability and feelings of connection. For example, the insight timer shows you how many other people across the world are using the insight timer at the same time.

2 Minute Beginner’s Guide Animation

Free

Why We Like It: Having a very quick, to-the-point, and accurate explanation can often be more helpful than a big, comprehensive tool.  We also like this explanation because it clarifies some of the common misperceptions of what mindfulness practice is.

Headspace

iPhone

Android

10 day free trial, subscription following trial

Why We Like It: This is a great app because the creators paid lots of attention to the interface.  This is the current industry leader, and it shows in the quality.  When you first begin to use it, the app has you watch a series of short and fun animations to quickly orient you to what mindfulness is and what it is not (the videos are worth watching).

Another reason why this app made our list is because the developers made it in a way that will have a higher likelihood of keeping you engaged over time.  Instead of moving on to something else once the initial motivation has passed, there is a greater chance you’ll stick with Headspace because each day has a different guided file, it gives you clear goals, and you get to choose to practice on specific issues (a series on anxiety, depression, pain, etc).

Insight Timer

iPhone

Android

iPad

Free for iPhone and Android with option of purchasing upgrades, $2.99 for iPad

Why We Like It: This app is worth acquiring for the Tibetan bells alone, but in the past year or so, the app has expanded to include a wide variety of meditation practices of varying lengths.

Stop, Breathe & Think

Web

iPhone

Android

Free

Why We Like It: This is a great app that works either on the computer or a smartphone.  It provides a great introduction and resources for taking your practice deeper, as well.  One thing it also does that the others don’t do is offer a check-in that will ask you questions about how you are feeling in order to suggest some useful types of mindfulness practice.

Tara Brach’s Guided Meditations

Free

Why We Like It: Tara Brach is most widely known for her book Radical Acceptance.  On her website she regularly posts guided meditations to follow along with.  Every meditation instructor has their own style, and Tara has an easy style that many people tend to like.  Additionally, we’d highly recommend listening to her her 2-part introduction to meditation talk:

Part 1 – Do You Make Regular Visits to Yourself (57 min)

Part 2 – Do You Make Regular Visits to Yourself? (55 min)

If you’d like to see our full list, please visit

Resources for Learning Mindfulness Meditation in Portland, Oregon

Beauty is the Beast: When love, caring, and kindness are experienced as threatening

Beauty is the Beast: When love, caring, and kindness are experienced as threatening

There is a new study out in the Journal Mindfulness entitled Mindfulness and Metta-based Trauma Therapy (MMTT): Initial Development and Proof-of-Concept of an Internet Resource. This pilot study tested the feasibility of an internet-based adjunctive intervention for addressing PTSD and related symptoms. Previous research has shown that a 12-week lovingkindness, or Metta, intervention was effective for reducing PTSD symptoms, with large effect sizes. This current study, in part, addressed whether similar effects could be found using an online intervention.

 

The MMTT intervention was comprised of several different tasks that participants could choose from including a thought-record-like journaling task, a mindfulness task in which participants indicated whether or not their mind had wandered every time a bell rang, a lovingkindness task, and psychoeducation. When the authors compared whether participants with different levels of PTSD symptoms differentially preferred each task, only one between-group effect emerged: people with higher levels of PTSD symptoms rated the lovingkindness meditation less favorably than people with lower levels of PTSD symptoms.

 

Without extrapolating too much based on these correlational findings, it is worth considering whether some groups of people may be more likely than others to have a threat response to love, caring, or kindness. In addition to the MMTT study, other research has also shown a link between PTSD symptoms and a threat response to positive events such as getting thanked, or receiving a gift. A self-report scale called the Hedonic Deficit and Interference Scale has been developed to assess this tendency. An example item from this scale is [after experiencing a positive event] do you experience shame and humiliation?

 

When the learning history of survivors of interpersonal trauma is considered, it is understandable how a threat response to care would develop. In the case of survivors of childhood trauma perpetrated by caregivers, for example, the same person who provides care is also the source of threat. But what about other groups that may experience a threat response to care? Perhaps people who are highly self-critical may be more likely to attack themselves following what they perceive to be “undeserved” care? Indeed, research on fear of compassion has demonstrated that being afraid of compassion is linked to higher self-criticism. In addition, maybe people who tend toward emotional over control and perfectionism would also be more likely to experience care as aversive.

 

The question of which populations experience a threat response to warmth and care is a relatively new one with potentially important implications for therapy.

UPCOMING TRAINING EVENTS

An Introduction to Exposure Therapy for Anxiety Disorders: Traditional and Inhibitory Learning Approaches

Dr. Brian Pilecki
January 29, 2021 from 12:00pm-1:30pm PST
Exposure therapy is the gold-standard treatment for anxiety and obsessive compulsive and related disorders. The aim of this workshop is to provide a solid foundation in theory and knowledge for those newer to exposure therapy. This workshop will include a brief history of exposure therapy, including a description of its roots in classical and operant conditioning. Read More.


Using Acceptance and Commitment Therapy to Guide Flexible Exposure

Dr. Brian Thompson
February 26, 2021 from 1-2:30pm

Drawing from the ACT model, participants will learn to conceptualize and create exposure exercises to maximize flexibility. We will explore common pitfalls in using ACT as a context for exposure and how to create ACT-consistent exposure exercises for clients who are skeptical of “acceptance” and appear disinterested when you try to engage them about values. The presenter will use practice-based data to support these principles (Thompson, Twohig, & Luoma, in press). Read More.


An Introduction to Psychedelic-Assisted Psychotherapy for Clinicians

Dr. Brian Pilecki and Jason Luoma, Ph.D.
March 26, 2021 from 9am-12:10pm

Psychedelic assisted therapy is emerging as a highly effective form of mental health treatment. This workshop will provide health care professionals an overview of this new clinical area. The workshop will highlight the importance of preparation and integration in therapy using a harm reduction approach. The current legal status of psychedelics will be reviewed, including Oregon’s recent passing of an initiative to legalize psilocybin-assisted therapy. Finally, diversity issues around lack of access for underserved and non-majority populations will be explored. Read More.


How to be Experiential in Acceptance and Commitment Therapy

Jason Luoma, Ph.D.
April 23, 2021 from 12-1pm

Acceptance and commitment therapy (ACT) is, at its core, an experiential treatment, but is frequently delivered in a non-experiential way. Experiential learning involves going beyond verbal discussion, insight, and explanations of experience. But how do we do this in ACT and how do we know when we are spending too much time engaged in non-experiential modes of learning? This workshop will outline a simple model you can use to identify when you are in less or more experiential modes during therapy and easy methods to switch to more experiential modes. You will then have a chance to practice it in breakout groups and get feedback. Read More.


Case Conceptualization in Acceptance and Commitment Therapy

Jason Luoma, Ph.D. and Dr. Brian Pilecki
May 21, 2021 from 12-2pm

This workshop provides a chance to learn concrete methods for conceptualizing cases from the perspective of Acceptance and Commitment Therapy. Formulating a useful case conceptualization is a foundational clinical skill that is essential in delivering effective treatment, and one that can be often overlooked in the process of working with clients. Participants will learn several formats for doing formal case conceptualization outside of session as a means to further develop knowledge and skill with ACT theory, as well as to learn a means to enhance treatment planning. The importance of ongoing case conceptualization throughout a course of treatment will be emphasized, as well as common pitfalls in conceptualizing client problems. Participants will also have a chance to practice newly learned skills with a case in breakout groups. Read More.


ACT Precision Training: In-Session Case Conceptualization in Acceptance and Commitment Therapy to Help You be Focused and Strategic in Your Interventions

Jason Luoma, Ph.D. and Jenna LeJeune, Ph.D
June 18, 2021 from 12-2pm

This workshop provides a chance to learn and practice in-session, in-the-moment case conceptualization of cases from the perspective of Acceptance and Commitment Therapy. This workshop focuses on helping you use ACT theory & in-session clinical markers to make more precise and strategic interventions. The main goal of this workshop is to help you become more adept at identifying in-session client behaviors that are indicators for particular ACT processes that are likely to be most relevant. The workshop uses a process we call ACT Circuit Training, which involves intensive analysis of a video of an ACT session and intentional practice in conceptualizing client behavior and generating possible ACT responses, followed by discussion and feedback. Read More.


ACT Agility Training: In-Session Case Conceptualization in Acceptance and Commitment Therapy to Increase Flexible Responding

Jason Luoma, Ph.D. and Jenna LeJeune, Ph.D
July 16, 2021 from 12-2pm

This workshop provides a chance to learn and practice in-session, in-the-moment case conceptualization of cases from the perspective of Acceptance and Commitment Therapy. This workshop is intended to help therapists be more flexible and nimble in their use of ACT processes, strengthening their ability to fluidly shift as needed between processes within sessions. Therapist learning ACT often develop tunnel vision, focusing too much on particular processes or responding rigidly when more flexibility is needed. 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.

December 11th, 2020 – Ethical and Legal Considerations in Providing Psychedelic Integration Therapy with Brian Pilecki, Ph.D. & Jason Luoma, Ph.D.
January 8th, 2021 – What’s it Like to Trip? The Patient Experience in Psychedelic-Assisted Therapy with Brian Pilecki, Ph.D.
February 12th, 2021 – 5-MEO-DMT with Rafael Lancelotta, M.S.
March 12th, 2021 – What does Psilocybin-Assisted Therapy for Depression Look Like? A Clinical Case Presentation based on a Recent Clinical Trial from Johns Hopkins with Alan K. Davis, Ph.D.
April 9th, 2021 – Gregory Wells, Ph.D.
May 14th, 2021  Research on MDMA and Psychedelic-Assisted Therapy: An Overview of the Evidence for Clinicians with Jason Luoma, Ph.D.