Podcast Fights Mental Health Stigma Using Acceptance and Commitment Therapy

In a time when the public discourse around mental health struggles is permeated with sweeping generalizations of “those” mentally ill people and calls to “lock them up,” a new podcast attempts to bring common humanity back into how we discuss the psychological suffering we all face as humans. Beyond Well with Sheila Hamilton incorporates an Acceptance and Commitment Therapy (ACT) perspective on the struggles we face, ideas about psychological flexibility and mental health, and what we can all do to lead a well-lived life.

Beyond Well – The Podcast

Started by Emmy Award winning journalist, author, and longtime mental health advocate Sheila Hamilton, Beyond Well is a podcast for the general public that aims to destigmatize and depathologize psychological difficulties while offering hope and resources to the listener. Each week the podcast features a guest, usually an author, musician, actor, activist or other person in the public eye, who talks openly and honestly about the struggles they have faced, whether that be anxiety, depression, substance use, racism, shame, trauma, or grief. In addition to Sheila, the podcast is co-hosted each week by psychologists and ACT therapists Brian Goff, Ph.D. and Jenna LeJeune, Ph.D., who incorporate ACT principles like acceptance, mindfulness, values, and defusion into the conversation. Along with each episode, listeners can also find written “After the Show Thoughts” that offer a deeper dive into some of the various themes and ACT principles discussed in the episode as well as resources.

Recent Guests

Beyond well covers a wide range of topics and features guests from all walks of life. Some recent guests include:  

  • Academy Award nominated documentary film maker Skye Fitzgerald talking about compassion fatigue and the migrant crisis in the Mediterranean Sea
  • Pop star Lauv talking about his struggle with depression
  • Award winning author Mitchell S. Jackson talking about racial identity
  • Activist Anna Debenham talking about her life-changing work with individuals who are incarcerated
  • Singer-songwriter, actor, and playwright Storm Large talking about being more than her labels and embracing all parts of herself
  • Bestselling author Cheryl Strayed talking about grief

Why Beyond Well Is the Fastest Growing Mental Health Podcast on Spotify   

Every guest has an inspiring and unique story to tell. But what unites all the episodes together is an idea fundamental to ACT — that psychological suffering is not some “abnormality” that happens to others, but rather an inescapable part of the human condition. The emphasis is on our shared humanity and on developing the psychological flexibility that allows us to live a life of meaning, purpose, and integrity even in the midst of that suffering. This perspective seems to be striking a cord with listeners. In just 7 months, the show has gained a tremendous following and is currently the fastest growing mental health podcast on Spotify.

How to Learn More

You can find Beyond Well on Spotify, SoundCloud, and iTunes, or go to the Beyond Well with Sheila Hamilton website for all the past episodes and other information.

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.

The 5-Minute Guide to ACT: A Visual ACT Elevator Pitch

The 5-Minute Guide to ACT: A Visual ACT Elevator Pitch

The challenge of explaining ACT

As an ACT trainer, one of the most challenging things for me is when someone who isn’t familiar with ACT says “What’s this whole ACT thing about?” Let’s just say my ACT elevator pitch needs some work! It’s tricky to try to describe something that is supposed to be an experiential therapy. And then there is the whole conundrum of trying to use language to explain a theory that holds that language is at the heart of the problem. But I find that “you just have to experience it” is the trainer equivalent to “because I said so” and is equally unsatisfying (and also not very helpful). So this week I was thrilled when I got another tool in my “what is ACT” arsenal thanks to ACBS member Dov Ben-Yaacov and the 5-minute Guide to ACT Pictogram he created.

The 5-Minute Guide to ACT Pictogram (click on picture to download)

This isn’t something I would necessarily share with clients. However, I do think this simple, yet surprisingly comprehensive pictogram could be very helpful in orienting students and those learning ACT to the general gestalt of how ACT, RFT, and Functional Contextualism fit together.

Another example of the generosity in the ACBS community

One of the things I most love about the Contextual Behavioral Science community is how incredibly generous the community is. I can’t imagine how much time it took Dov to create this. And then he just went ahead and posted it for anyone to use it for free. So it’s with much gratitude to Dov Ben-Yaacov that I pass this along to you. Please use it as it is helpful and also continue to credit Dov Ben-Yaacov as you do so.

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.

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.