Treatment Planning & Protocols Flashcards

A client with OCD is referred for ACT. How does the ACT treatment plan differ from an ERP-only protocol?

Answer: ACT adds values-based motivation and acceptance of uncertainty while still using exposure

ACT complements exposure by helping clients clarify why tolerating OCD discomfort matters (values) and building willingness to experience anxiety without compulsions.

Which scenario best illustrates 'creative hopelessness' as used in ACT treatment planning?

Answer: The therapist helps the client notice that control-based strategies have not produced lasting relief

Creative hopelessness invites clients to examine the workability of their avoidance strategies, creating openness to a new (acceptance-based) approach.

In an ACT protocol for depression, 'behavioral activation' is reframed as:

Answer: Committed action toward values even in the presence of low mood

ACT behavioral activation is values-driven committed action, where the motivation comes from what matters rather than mood improvement or pleasure.

A treatment plan notes that a client needs to 'build self-as-context.' A therapist would primarily use which intervention?

Answer: The 'observer self' exercise to contact the stable, perspective-taking sense of self

Self-as-context is developed through 'observer self' or 'chessboard' exercises that help clients contact a stable point of awareness distinct from their thoughts and feelings.

When working with adolescents in an ACT protocol, treatment planning should primarily account for:

Answer: Adapting language and exercises to developmental level while preserving ACT processes

ACT with adolescents requires developmentally sensitive language and relatable metaphors, but all six core processes remain valid treatment targets.

A client is mid-protocol and shows increased values clarity but unchanged experiential avoidance scores. The ACT therapist should:

Answer: Re-emphasize acceptance and defusion work, as avoidance remains a barrier to committed action

High experiential avoidance despite values clarity indicates that acceptance and defusion skills need more attention before committed action will be sustainable.

In ACT case conceptualization, 'fusion' with rules is treated as a clinical problem because:

Answer: Rigid rule-following can override flexible, values-based responding to the current context

Excessive fusion with rules (e.g., 'I must never feel anxious') leads to inflexible behavior that prioritizes following the rule over responding effectively to context.