Dancing around the hexaflex: Using ACT in practice 2
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists (remember ACT is open for anyone to use it!) can use ACT in session.
Self as context
From my experience, this process is possibly the least well understood of the ACT hexafle...
Source: HealthSkills Weblog - August 27, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Pain conditions Professional topics Science in practice acceptance and commitment therapy Clinical reasoning Occupational therapy Therapeutic approaches Source Type: blogs
Dancing around the hexaflex: Using ACT in practice 1
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists (remember ACT is open for anyone to use it!) can use ACT in session.
Mindfulness – messing about with attention
Thanks to Kevin Vowles, I’m adopting t...
Source: HealthSkills Weblog - August 20, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Back pain Chronic pain Clinical reasoning Coping strategies Low back pain Occupational therapy Physiotherapy Psychology Research Resilience Resilience/Health Science in practice mindful movem Source Type: blogs
Acceptance and Commitment Therapy: It ’ s not about giving up
Last week someone asked how I can reconcile using Acceptance and Commitment Therapy (ACT) alongside hypnosis, because ACT is all about giving up on pain reduction. This belief is common I suppose because ‘acceptance’ is in the name, and acceptance means ‘giving up’ (Biguet et al., 2015). It might also come about because ACT is so often helpful for people with chronic or persistent pain, though I’ve heard some commentators argue that ACT is unhelpfully used with people who may still have pain resolution or reduction available to them.
I can’t comment on when or how ACT is used, but I c...
Source: HealthSkills Weblog - August 13, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Clinical reasoning Coping strategies Pain conditions pain management Therapeutic approaches Source Type: blogs
Clinical indications for hypnosis
Who might benefit from learning hypnosis – and when might you suggest it?
I’m a person who doesn’t really try changing my own pain intensity very often, and most of the people I’ve worked with in therapy are also in the stage of wanting to learn how to live alongside their pain. However, there are some times when modulating pain intensity can be a really helpful part of even this phase of learning to live well with pain.
I haven’t found any clinical guidelines suggesting when it might be good to introduce hypnosis, so this is my own clinical reasoning. Remember I work with a particular g...
Source: HealthSkills Weblog - August 6, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping Skills Coping strategies Resilience/Health Science in practice Clinical reasoning hypnosis Occupational therapy self-hypnosis Source Type: blogs
… you are feeling sleepy …
Hypnosis could be one of the least respected yet most effective self-help pain reduction strategies we know of. Surprised? You shouldn’t be! Hypnosis has such a lot of baggage, most of it completely unrelated to the way it is used in the clinic. Once we dig just a little more deeply into how it can be used and the effects it has on a person’s pain (and as shown in fMRI studies and experimental studies) we can see that there are some things our mind can do that are literally mind-boggling!
What is hypnosis? Simply put it’s a state of focused attention that allows us to be open to suggestions for changes...
Source: HealthSkills Weblog - July 30, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Coping strategies pain management Therapeutic approaches Source Type: blogs
What we can learn about rehab from my dog
Miss Molly May is my adorable, high energy, full-sized labradoodle. She’s five years old, and has just undergone a tibial plateau leveling osteotomy for her right rear knee. Essentially she damaged the dog equivalent of her cruciate ligament because she’s an idiot. Well, she’s a dog who adores chasing the B-A-L-L and the F-R-I-S-B-E-E and any random S-T-I-C-K at full speed, turning really fast to catch it before anyone else gets to it.
Five weeks ago she was seen by our local general practice vet, referred to animal physio (click) and comprehensively examined there, then referred to the Animal Orth...
Source: HealthSkills Weblog - July 9, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Coping strategies biopsychosocial Clinical reasoning Health healthcare Therapeutic approaches Source Type: blogs
What goes on in the brain matters
I am the first to say (quite loudly at times) that pain is a whole person experience. I say this because my experience of pain is mine and utterly unable to be shared in all its complexity. The only way other people know about my pain is through my actions – both involuntary and voluntary. And even then: the way I express myself differs depending on my social context, my mood, my goals, and what I think my pain represents. Yet when I’m asleep, I don’t have pain, when I have anaesthetic for my colonoscopy, I don’t have pain – so what goes on in my brain is kinda important.
Now there have bee...
Source: HealthSkills Weblog - June 25, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Pain conditions Research Therapeutic approaches Source Type: blogs
Is it really depressing? Really living with chronic pain
Someone responded to my post Unpalatable truths about pain saying it was depressing. For a moment I thought – yeah, it is really. And then I reflected on my life living with, and working with people dealing daily with chronic, ongoing, persistent pain. It’s not inevitably miserable. Is there something wrong with me?
This, of course, set me to thinking maybe my pain isn’t as intense as others. Well – how would I know? I can’t give my pain a number out of 10. It’s just there and I can’t remember a time without any pain, so I can’t compare a 0 = no pain at all with anything ...
Source: HealthSkills Weblog - June 18, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Pain conditions Psychology Research Resilience/Health Science in practice Wellness pain management Therapeutic approaches Source Type: blogs
Unpalatable truths about pain
Recently I read a blog post about the way “Explain pain” had landed with a group of people in the general public. The point being made was that people found the ideas presented unpalatable. They didn’t agree with the points and they thought the ideas were dismissive of their experience.
Now I am a critic of any recipe-based approach to helping people. I am especially a critic of clinicians using something they’ve picked up on a weekend course, or out of a book, being applied holus bolus to an individual without nuance. There have been outrageous claims made about the effectiveness of giving some...
Source: HealthSkills Weblog - June 11, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Pain conditions Professional topics biopsychosocial pain management Therapeutic approaches Source Type: blogs
The power of being present
I’ve been listening to Prof Kevin Vowles recently, as he presents his approach to pain using ACT. He made an important point about mindfulness that resonated with me: it’s that when learning to be fully present, it’s not how long we stray from our point of focus, nor even how many times we come back, the learning is that we can come back. Again and again and again.
There are arguments about what mindfulness is, and I’m certain these will continue, but for the purposes of this post and for people just learning mindfulness, I’m defining it as the deliberate practice of attending to a focus (t...
Source: HealthSkills Weblog - May 28, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Professional topics Research hypnosis mindfulness Therapeutic approaches Source Type: blogs
New! Awesome! Better! (Learning a new approach)
With all the attention being given to cognitive functional therapy (and deservedly so, IMHO) it’s tempting to leap aboard the modality train and go take a course, isn’t it?
Although I’ve picked on CFT today, it could just as easily have been any of the New! Awesome! Better! therapies that hit the clinical headlines on a frequent basis. The temptation to go “Look! Shiny!” and learn about the latest thing isn’t confined to teenagers following some social media trend. Yup, even sober-sides nearly 60-year-olds like me still want to go on learning, getting better at what I do, keeping up w...
Source: HealthSkills Weblog - May 21, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Clinical reasoning Education/CME Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice biopsychosocial healthcare Therapeutic approaches Source Type: blogs
Pain Concepts for Practice: Occupational therapists
Enrolments open again for this online course with THREE live Zoom discussions!
This course is specifically developed for occupational therapists and gives you:
an overview of the THREE groups of pain mechanisms and a way through the neurobiology maze
what pain mechanisms mean when working with people experiencing pain
the weird and uncertain influence of pain on daily life
pain behaviours and how these can get in the way of doing what matters to a person
pain assessments and what they mean
sensory approaches for people living with pain
graded desensitising and graded exposure – how they are n...
Source: HealthSkills Weblog - May 18, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
Learning ACT (acceptance and commitment therapy)
Around 2001 I read what I believe is the first randomised controlled trial of ACT for people living with chronic pain (McCracken, 1998). I quickly dived into this ‘new’ therapy – it appealed to me because it resonated with my own experiences with psychological therapies for depression, and in the way I had learned to live alongside my own pain. For those who don’t know, I developed chronic pain around the age of 22ish (dates are hard to remember!) and after seeing a pain specialist was given those fateful words ‘I’m sorry, there’s nothing we can do from a medical perspective.’...
Source: HealthSkills Weblog - May 14, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: 'Pacing' or Quota ACT - Acceptance & Commitment Therapy Chronic pain Motivation Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice acceptance and commitment therapy Therap Source Type: blogs
Why I ’ m not fazed by unremarkable results in therapy trials
Remember the old ‘pareto principle’? 80% of the results come from 20% of the input, or as Wikipedia informs me, “the principle of factor sparsity”
I think we’ve got there with musculoskeletal pain, especially low back pain.
The other ‘law’ that might apply is that of diminishing returns.
We’ve learned a great deal about low back pain over my clinical career. We’ve essentially learned what not do to. In the name of progress, thousands of people have put their pain (their bodies) on the line. And progress has not exactly been great right? We’ve learned tha...
Source: HealthSkills Weblog - May 7, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Low back pain Occupational therapy Pain conditions Physiotherapy Professional topics Research Science in practice healthcare Therapeutic approaches Source Type: blogs
“ … someone needs to find the cause of my pain, then fix it. ” What to do with sticky beliefs
I think most clinicians, and certainly a lot of people living with pain, want to know ‘what’s going on’ – with the hope that, once identified, ‘something’ can be done. Tricky stuff to navigate both as a person living with pain, and as a clinician – because for so many chronic pains, a diagnosis does very little.
Having a label has some benefits, for sure: it acts as a short-hand when talking about what’s going on with others; it can validate that the mysterious problems a person has been having are ‘real’ (though I could say more about that!); it can help peop...
Source: HealthSkills Weblog - April 30, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Clinical reasoning Coping strategies Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice biopsychosocial pain management Therapeutic appr Source Type: blogs
