Mindfulness- and Acceptance-Based Behavioral Therapies in Practice


Accessible and practical, this book provides a unified framework for integrating acceptance and mindfulness into cognitive-behavioral practice. The authors interweave elements of acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based relapse prevention, and dialectical behavior therapy. They demonstrate how to conduct an assessment, develop a case formulation, and derive a flexible treatment plan for each patient. Vivid case examples and transcripts illustrate the entire process...

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Accessible and practical, this book provides a unified framework for integrating acceptance and mindfulness into cognitive-behavioral practice. The authors interweave elements of acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based relapse prevention, and dialectical behavior therapy. They demonstrate how to conduct an assessment, develop a case formulation, and derive a flexible treatment plan for each patient. Vivid case examples and transcripts illustrate the entire process of therapy, showing how treatment can be tailored for different presenting problems and concerns. More than two dozen reproducible handouts and forms are included.

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Editorial Reviews

The Family Journal

"Students have expressed a need for a unifying framework, through which they can sufficiently support and challenge clients to expand their affective, cognitive, and behavioral skills and experiences. The text of Roemer and Orsillo provides just the answer. All readers—whether students, practitioners, or educators—can benefit from the well-supported theoretical grounding of the mindfulness and acceptance-based behavioral therapeutic (ABBT) approaches provided as well as the detailed description and synthesis of numerous, evidence-based practices associated with both. Although any of the 11 chapters...can stand alone as a credible source of indispensable information, read together in their entirety, they offer the reader a practical and easily accessible means to integrate mindfulness and ABBT approaches in their clinical work with clients."--The Family Journal

"This book is timely and innovative in its approach to clinical work. It is a very thorough, well-researched, and scientifically sound book with a plethora of references. This is certainly gratifying and sets it apart from other books aimed at the practicing clinician....This book is an informative and well-researched approach to an exciting and promising area of practice. It is likely to deepen the clinical understanding of the beginning clinician or postdoctoral candidate."--PsycCRITIQUES
Journal of Mental Health

"The book provided a robust introduction to Mindfulness, including a section on the current evidence base for the approach. It goes on to take the reader through the process of therapy from the initial history taking to evaluation of the therapy and relapse prevention. Each section is thorough but readable and the incorporation of case studies and examples of therapeutic dialogue is well balanced. The text provides a detailed section on the assessment process and tailoring of the approach to suit individuals. The chapter focusing on cultural considerations is a great asset to the book and helps to make the book relevant to professionals working within diverse communities. The book reads very well and provides a good explanation of mindfulness giving it a broad appeal to a range of professionals....The extensive supply of handouts, information sheets, and self-assessment documents provides a great resource base for therapy....A thorough yet accessible guide to Mindful and Acceptance based therapy for both the experienced therapist and the curious trainee."--Journal of Mental Health
Cognitive Behaviour Therapy

"A well-written, comprehensive, and consumer-friendly guide to mindfulness-and acceptance-based behavioral therapies....The authors incorporate material from a range of evidence-based interventions....In this way, the authors make the book relevant to clinicians interested in learning about important elements and principles across the range of existing mindfulness- and acceptance-based therapies....This book provides a useful guide for clinicians who are interested in learning about and utilizing mindfulness-and acceptance-based therapeutic concepts, and it would make a valuable addition to any clinician's library."--Cognitive Behaviour Therapy
From the Publisher

"Wide ranging in its coverage and grounded in its delivery, this book illustrates the nuts and bolts of mindfulness- and acceptance-based clinical care without straying far from the authors' behavioral roots. This impressive volume will prove indispensable to therapists, students, and researchers eager to learn about the promise these models hold."--Zindel V. Segal, Departments of Psychology and Psychiatry, University of Toronto, Canada

"This outstanding book describes the most up-to-date conceptualizations of mindfulness- and acceptance-based procedures, which are components of most, if not all, successful therapies. The authors present a modular approach for integrating these empirically supported techniques into the treatment of patients with diverse problems. This is the shape of things to come--a book that should be read by every clinician and clinical trainee who wants to stay abreast of advances in psychological treatments."--David H. Barlow, PhD, ABPP, Professor of Psychology and Psychiatry, Boston University, and Founder and Director Emeritus, Center for Anxiety and Related Disorders

"This timely and important volume offers an insider’s view of what is essential and unique about mindfulness- and acceptance-based treatments. The authors show how core mechanisms of therapeutic change, derived from clinical science, can be flexibly applied in therapy that is client centered, compassionate, and emotionally connected. They provide a nuanced understanding of complex theoretical issues and how they bear on actual treatment. This readable book will be welcomed by seasoned clinicians for its conceptual clarity and wealth of clinical exercises, and by beginning therapists as a trustworthy guide to acceptance-based behavioral treatment."--Christopher K. Germer, PhD, private practice, Cambridge, Massachusetts

"With the growing interest in mindfulness- and acceptance-based behavioral therapies, many practitioners and students are seeking a practical book like this one to fill a gap in their training. The volume offers a detailed, step-by-step explanation of each phase of assessment, case conceptualization, and treatment. I highly recommend this excellent, well-written, theoretically informed guide."--Gabriele Melli, PhD, President, Institute of Behavioral and Cognitive Psychology and Psychotherapy of Florence, Italy

"Roemer and Orsillo provide a practical, balanced, and comprehensive review of mindfulness- and acceptance-based treatments for anxiety, depression, and a range of other problems. They also discuss how these strategies can be used in the context of other behavioral approaches. This is an essential book for anyone planning to integrate mindfulness and acceptance-based strategies into his or her clinical practice, from the novice to the seasoned therapist."--Martin M. Antony, PhD, ABPP, Professor and Director of Graduate Training, Department of Psychology, Ryerson University, Toronto, Ontario, Canada


"Strong and insightful both on theory and practice. The book includes an abundance of useful and reproducible handouts, which form an integral part of mindfulness and acceptance therapy; both self-monitoring forms and psycho-educational materials....It also provides an enlightening overview of the similarities and differences between the initially bewildering array of approaches within the 'family': acceptance and commitment therapy (ACT), mindfulness-based cognitive therapy (MBCT), mindfulness-based relapse prevention (MBRP), dialectical behavior therapy (DBT), and of course the original cognitive therapy (CT)....A comprehensive guide is given to assessment, case conceptualization, and the treatment itself....I encourage all mental health practitioners to read it."--CounsellingResource.com
Doody's Review Service
Reviewer: Christopher J Graver, PhD, ABPP-CN(Madigan Healthcare System)
Description: With cognitive behavioral therapy (CBT) so entrenched in psychotherapists' offices, it's not surprising to see variations of this approach growing in popularity. Mindfulness-based therapies offer a twist to the traditional CBT approach and this book provides a guide to these approaches.
Purpose: The aim of this book is to bring together different mindfulness- and acceptance-based practices within a CBT context and present a practical framework for implementing these therapeutic methods.
Audience: Mental health professionals and paraprofessionals, as well as students learning psychotherapy, are an appropriate audience. The authors are involved in clinical research on the use of these approaches in various disorders.
Features: For readers unfamiliar with acceptance-based therapies, the introductory chapter begins with a review of these approaches, as well as a review of the scientific literature supporting their use. The next few chapters help to revisit tenets of CBT, as well as the unique contribution of an acceptance-based approach. There are practical suggestions throughout the book, such as guidance in assessment, how to introduce acceptance-based approaches, structure of the session, and assignments. Handouts and measures are included, along with a copyright provision for the reproduction of these in professional use. After the discussion of these specific topics, chapters help to bring the pieces together and then to monitor progress and prevent relapse. This is not seen as a solitary approach and there is a chapter regarding the incorporation of other strategies. The book concludes with a reflective chapter on multicultural considerations, always a welcome addition to psychotherapy work. The references are pertinent and current.
Assessment: An appropriately practical book, this latest addition to the psychotherapy literature will be helpful to readers of all levels exploring mindfulness- and acceptance-based therapies. Whereas the book is more structured than The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness, Williams, et al. (Guilford, 2007), it is not quite as engaging and doesn't draw the reader in. The structured versus narrative, exploratory approach will likely be a personal preference for readers, but either book is recommended.
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Product Details

Meet the Author

Lizabeth Roemer, PhD, is Professor of Psychology at the University of Massachusetts/n-/Boston, where she is actively involved in research and clinical training of doctoral students in clinical psychology. In collaboration with her students, her research examines basic processes that may underlie clinical problems, such as the role of emotional acceptance, emotional suppression, emotion regulatory strategies, and mindfulness in a range of clinical presentations. Dr. Roemer has published over 70 journal articles and book chapters, coedited two books, and coauthored two books.
Susan M. Orsillo, PhD, is Professor of Psychology at Suffolk University in Boston, Massachusetts. Her current research focuses on the role of emotional response styles, most notably experiential avoidance, in maintaining psychological difficulties. In collaboration with her doctoral students in clinical psychology, she has developed a number of prevention and treatment programs that integrate acceptance and mindfulness with evidence-based behavioral approaches. Dr. Orsillo has published over 70 journal articles and book chapters, coedited two books, and coauthored two books.
Together, Drs. Roemer and Orsillo have developed an acceptance-based behavioral therapy for generalized anxiety disorder. They are currently examining its efficacy as well as mediators and moderators of change in a study funded by the National Institute of Mental Health. Their self-help book The Mindful Way through Anxiety draws from their decade of research in this area to provide guidance to people struggling with anxiety.

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Table of Contents

Introduction 1

Defining the Approach 2

Current Status of Empirical Support for Mindfulness- and Acceptance-Based Behavioral Therapies 4

1 An Acceptance-Based Behavioral Conceptualization of Clinical Problems 17

Restricted, Entangled, Fused Internal Awareness 20

Experiential Avoidance 25

Behavioral Constriction: Failure to Engage in Valued Action 30

Goals and Methods of Intervention 31

Conclusion 33

2 Clinical Assessment of Relevant Domains 34

Symptom-Based Assessment 35

Relationship to Internal Experiences 39

Current and Past Coping Strategies 42

Quality of Life 44

Previous Treatment 47

Additional Assessment Resources for the Clinician 50

3 Individualized Case Formulation and Treatment Planning 54

Developing a Case Formulation 54

Example of a Case Formulation 62

Linking Case Formulation to Treatment Planning 63

4 Setting the Stage for Therapy 65

Brief Overview of the Treatment Approach 65

The Therapeutic Stance 69

Introducing the Client to Treatment 74

5 Offering the Client an Acceptance-Based Behavioral Model of Human Functioning 83

Methods of Presenting Information 84

Sharing the Model of Human Functioning and Challenges 85

Challenges in Presenting Models 99

6 Mindfulness- and Acceptance-Based Strategies 115

The Nature of Acceptance 115

Cultivating Acceptance through Mindfulness-Based Practice: An Overview 116

Specific Instruction and Practice in Mindfulness- and Other Acceptance-Based Practices 119

Obstacles in Cultivating Mindfulness and Acceptance 133

7 Setting the Stage for Behavioral Change 142

An Introduction to the Concept of Values 143

Initial Values Assessment 148

Articulating and Clarifying One's Values 152

Increasing Awareness of Action and Inaction in Valued Domains 160

8 Putting It All Together: Promoting Mindful, Valued Action 168

Preparing to Move from Values Articulation to Values-Consistent Behavior 169

Making a Commitment to Valued Actions as a Part of Daily Life 171

Obstacles to Committed Action 172

Willingness to Make a Commitment 174

9 Evaluating Progress, Relapse Prevention, and Ending Treatment 182

Continual Assessment of Progress 182

Relapse Prevention 188

Ending the Therapeutic Relationship 192

Challenges That Arise during Termination 194

10 Incorporating Other Evidence-Based Interventions with Acceptance-Based Behavioral Therapies 201

Cognitive Therapy 202

Exposure Therapy 208

Behavioral Activation 210

Relaxation Training 211

Skills Training 212

Medication 213

Summary 214

11 Cultural Considerations in Acceptance-Based Behavioral Therapies Jonathan K. Lee Cara Fuchs 215

The Relevance of ABBTs to Clients from Diverse Backgrounds 216

Adapting ABBTs for Clients from Diverse Backgrounds 220

Summary and Conclusions 227

Appendix Mindfulness Books 229

References 230

Index 239

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