Social phobia & acceptance and commitment therapy (ACT)

Social phobia & acceptance and commitment therapy (ACT) RAHİME ŞEKER

OUTLİNE

phobia • phobia is a irretional, intensepersistentfear of specificsituations, activitiesthingorpeople. • excessiveunreasonabledesiretoavoidfearedobjects.

Socialphobia • An anxietydisorder • Social phobia is a strong fear of being judged by others and of being embarrassed. This fear can be so strong that it can harmwork life or school life or doing other everyday things.

http://www.youtube.com/watch?v=4mAKwDmBAi0

symtoms • Symptoms include chest pains, sweating, fear, insomnia, constant panic, dry mouth, sleep disturbances, pain attacks, indigestion, fast heartbeat, difficulty in breathing, headaches and uncontrollable thoughts. • In extreme cases the inability to leave home, phobias of all types, social discomfort, poor memory or obsessive thoughts.

Genetic & environmentalfactors • Submissiveness, anxiousness, social avoidance and behavioural inhibition have genetic component • Influence of parent-child interactive style. Parents: • Exert greater control • Show less warmth • Are less sociable • Use shame to discipline child

Cognitivefactors • Information andinterpretation bias • Interpret performance significantly more critically • Show self-focussed attention • Indulge in excessive post-event processing of social events

DSM-IV-TR Diagnostic Criteria for Social Phobia

The Prevalence of Social Phobia • Prevalence rate of 7-13% in Western Societies • Afflicts females more than males • Age of onset is typically mid-teens

Drugtreatments • CognitiveBehavioralTherapy (CBT) • Accptenceandcommitmenttheraphy (ACT)

AcceptanceandCommitmentTherapy (ACT) • ACT is a psychological intervention based on modern behavioural psychology, that applies mindfulness and acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility

ACT aims to; • enable us to have the psychological flexibility to experience both good and bad feelings, • control our behaviour to create meaningful and rich livesbyusingacceptanceandawarenesstechnique

ACT is comprised of 6 core processes that are displayed in a diagram called the hexaflex

Contact with the Present Moment Acceptance Values Acceptance Commitment Therapy Defusion Committed Action Self-As-Context

Acceptance; it is better described by the word willingness, it meansto be willingtoexperiencebothnegativeandpositivefeelings. • Defusion; aims to create distance between the client and their thoughts • Beingpresent; Too many of us live our lives ruminating on the past or worrying about the future, it helpstocontact with the present moment, and all that it offers us. Alsocalledmindfullness. • Self as context; manypeoplehavestoryaboutwhoweare, sometimes this storyabout‘who we are’ (the conceptualized self) make us inflexible and rigid in our behavior

Defining Valued directions; What are the things that are most important to you • What are the things you care about most • What would you like written on your tombstone • In many areas of life we lose touch with the things important to us • Family • Friends • Career • The environment • Religion • Health

Committed Action; ACT encourages he development of larger and larger patterns of behavior linked to the clients values • Clinicians will set achievable goals for their clients • And then they will look at the possible barriers to achieving their goals and underlying values

METAPHORS; • Shortstorieswhichare used to clearly demonstrate the principle the therapist talks about. • Passenger on bus • demons on theboat • Zombie • Joethebumb

willingness • Willingness can be defined as ‘being open to one’s whole experience while also actively and intentionally choosing to move in a valued life direction. • Willingness is on-going – we can never achieve it, simply continue to choose willingly in each situation

Using ACT • Willingness is often decided by the context i.e. a social phobic could be willing in a bookstore, but not a shopping centre, he or she could be willing for five seconds or for one hour • Therapists would usually start by asking the client to be willing in a small way, then increase the steps with time. Passanger on thebusmetaphor

Using ACT Theraphistteachesclienttheunderstanddifferencesbetweenthinkingandbehaving (defusion) Helpthemtostay at the moment (beingpresent) Helpthemtoregulatetheir self context (self es context) Helpthemto define values Helpthemtocommitaction

So far, • Social phobia • Acceptance and commitment therapy • Sample case

Referencelist • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition (2000). Washington, DC: American Psychiatric Association. • Harris, R. (2006). Embracingyourdemons: An overviewacceptanceandcommitmenttheraphy. Psychotheraphy in Australia, 12, 1-8.

Social phobia & acceptance and commitment therapy (ACT)