What is acceptance and commitment coaching? - Chapter 10

This chapter described the theoretical underpinnings, empirical support, key concepts, tools and strategies of acceptance and commitment coaching. Acceptance and commitment (AC) coaching aims to help clients increase their psychological flexibility, a state that is characterized by being clear about living in harmony with your own values, spending time in the present moment, defusing and gaining separation from thoughts, accepting unwanted, unpleasant and unhelpful feelings and sensations and cultivating the perspective of observing the self. Different from other cognitive-behavioural coaching approaches, AC coaches help their clients to change their relationship with their cognitions rather than trying to change their form or content of their client's thoughts. Clients are guided and encouraged to notice the rise and fall of unpleasant and unhelpful thoughts and feelings, and to take these with them as they go about living the life they want for themselves.  

What is the evidence base of acceptance and commitment coaching?

AC therapy (ACT) is extensively evaluated as an approach to help people. It has proven effectiveness under various conditions. In addition, many correlational studies have found a correlation between scores on the Acceptance and Action Questionnaire (AAQ) and measures of psychopathology and life. The AAQ measures the degree to which an individual fuses with thoughts, avoids feelings, and is unable to act in the presence of difficult private events. Further, evidence of varying quality also support the effectiveness of ACT in various conditions, such as borderline personality disorder, multiple sclerosis, and substance abuse.

ACT is based on a form of pragmatism known as functional contextualism. The unit of analysis is the 'ongoing act in context' and the context in which a particular act takes place is key to a proper understanding of its function. ACT further builds upon the Relational Frame Theory, an approach to language and cognition that attempts to provide basic principles for all forms of cognitive intervention. RFT explains human psychological issues as arising because derived relations dominate over other sources of behavioural regulation and because humans have difficulty detecting the ongoing process of thinking as distinct from products and objects of thinking (thoughts). 

How to apply acceptance and commitment coaching in practice?

Key concepts in AC coaching are: private experience, experiential avoidance, psychological flexibility, cognitive fusion, workability, and common humanity. 

Private experience

Private experience refers to those things that we experience inside our minds and which are not available for other people to experience. Private experiences can be further distinguished using the acronym EMITS: (a) emotions and feelings; (b) memories; (c) images; (d) thoughts; and (e) sensations. One key task of the AC coach is to help the client to accept that however unpleasant or painful these private experiences may be, they are not the main issue or problem. The main issue, instead, is how they react to and try to deal with these private experiences. 

Experiential avoidance

Much of what we experience inside our minds and bodies is unhelpful or unpleasant. We therefore may tend to experiential avoidance, the tension to avoid situations that seem to bring on these uncomfortable experiences and / or to reduce the intensity and duration of these experiences once we cannot avoid them. This avoidance is considered by the coach as the main problem. That is way a large part of what the coach is doing, is focused on psychoeducation and Socratic questioning in order to help the client to reframe what is that needs to change. 

Cognitive fusion

Cognitive fusion is a process that involves attaching a thought to an experience. Cognitive fusion is beneficial in many ways. Through the process of cognitive fusion, people can become interested in story lines in movies and books because they attach their emotions to the events. These thoughts can become stuck to our minds and follow us around, forcing us to see the world through their unhelpful perspective: 'you are a loser' or 'you will never be able to do this'. No matter how hard we try, we cannot seem to shake these thoughts off. One technique for helping the client is by asking them: 'to what extent does this thought or belief help you in making progress towards your goals in life?'. In doing so, it is important to do so with empathy and compassion, rather than with a sarcastic tone. 

Common humanity

Common humanity refers to the fact that we all struggle. In different ways, of course, but we all have our frustrations and struggles. The AC coach helps the client to accept that they are not alone in their suffering and experiencing the frustrations that they do. 

Psychological flexibility and the RAMP model 

Psychological flexibility is both strived for by the coach and the client. It enables us to make progress towards valued goals and to live lives of better quality. People who lack psychological flexibility tend to have a lack of clarity about what is important to them; tend to have a lack of contact with the present moment; and tend to avoid unpleasant or unwanted thoughts, feelings, and sensations. AC coaches try to guide their clients from psychological inflexibility towards psychological flexibility. To do so, the coach can use the RAMP model. This model shows how psychological flexibility is increased by making progress in each of the six domains or psychological processes: 

1. Observing self
2. Contact with present moment
3. Disentanglement
4. Acceptance
5. Committed action
6. Valued living

Finally, to help clients to make progress and experience more psychological flexibility, AC coaches help their clients to:

• Clarify their values.
• Take committed action, for instance by setting short-term and long-term goals in harmony with their values.
• Accept unwanted thoughts and feelings.
• Defuse and disentangle from certain thoughts, beliefs and images.
• Contact the present moment.
• Cultivate the observing self.

When might AC coaching be most suitable?

AC coaching is proven helpful under various conditions. However, it is important to notice that many elements of this approach are not unique. For example, many coaches help clients to clarify their values, to set goals that are in harmony with their values, and to take action towards these goals. Probably the main difference between AC coaching and other forms of (cognitive behavioural) coaching is its emphasis on reducing experiential avoidance and increasing psychological flexibility and on noticing, accepting, and making space for unpleasant thoughts and feelings rather than trying to challenge or change them.

This chapter described the theoretical underpinnings, empirical support, key concepts, tools and strategies of acceptance and commitment coaching. Acceptance and commitment (AC) coaching aims to help clients increase their psychological flexibility, a state that is characterized by being clear about living in harmony with your own values, spending time in the present moment, defusing and gaining separation from thoughts, accepting unwanted, unpleasant and unhelpful feelings and sensations and cultivating the perspective of observing the self. Different from other cognitive-behavioural coaching approaches, AC coaches help their clients to change their relationship with their cognitions rather than trying to change their form or content of their client's thoughts. Clients are guided and encouraged to notice the rise and fall of unpleasant and unhelpful thoughts and feelings, and to take these with them as they go about living the life they want for themselves.