Working with values – Harris (2009; p197-200) provides a script that demonstrates how a skilled ACT therapist guides a conversation with a client who is struggling with confusion over how to handle a very challenging problem. The script illustrates how to help the client get in touch with her deepest values and how this can help clarify a path forward. It also illustrates how to navigate several of the pitfalls such as guilt and fear of failure that are pervasively present when we struggle with our values.
Many techniques have been developed to help clients clarify their values. These can be used to start the conversation or at later points when uncertainty arises about which values are most important in different situations. The following list is adapted from Harris (2009; p201).
Likes – What do you like to do? What is it about these things that you enjoy?
Role models – Who do you look up to? Who inspires you? What personal strengths or qualities do they have that you admire?
Disapproval – What do you disapprove of or dislike in other people or in the ways they behave? How would you want to act differently if you were in their shoes?
The sweet spot – What is the best memory that you have from life up until now. What were the emotions that you felt at the time? Why is this memory so important to you?
Childhood dreams – Remember a time in your childhood when you were happy. What sort of life did you imagine for the future?
Character strengths – What personal strengths and qualities do you already have? Which new ones would you like to develop? Why?
Speeches about you – Imagine your 21st birthday (or your 50th birthday, or graduation or retirement party. Two or three people make speeches about what you stand for, what you mean to them, the things you contributed to their life. In the IDEAL world, where you have life your life as the person you want to be, what would you like to hear them say?
Life and death – Imagine your own funeral; imagine what you would like to hear people saying about you. Alternatively, imagine you somehow know that you only have 24 hours to live. Who would you visit? What would you say to them?
Magic wand – Imagine that I wave a magic wand and all of these painful fears, feelings and memories no longer have any impact on you. What would you do with your life? What would you start, stop, do more of, or less of? How would you behave differently? If we watched you on a video, what would we see and hear differently that would show us the magic had happened?
Missing out – When you think about all the time that you have been affected by very painful thoughts, feelings and memories?
If …then … - Think about [that goal that you want to achieve]. When you achieve that goal what will change for you in your life? What will you do differently from then on? How will you behave differently with your family and your friends and other people?
The questions suggested for each of these techniques are intended as conversation starters to be adapted and expanded flexibly as appropriate to the context. Harris provides an extended script to illustrate how an ACT therapist could guide a client through a visualisation of the 'Speeches about you' technique (Harris 2009; p.202-203).
Many barriers and difficulties arise when working on value clarification:
Emotional pain – The biggest barrier to values work is due to the inevitable emotional pain that it provokes for clients. This is particularly true for people who have experienced problems with substance misuse and other mental health problems that have contributed to repeated neglect, hurt, and abuse of their own bodies, partners, family members, and friends. To reconnect with values such as caring and loving inevitably brings up all the pain associated with these events.
Avoidance and fusion are common responses when a client is trapped in pain or is otherwise not ready to work on values. Avoidance will manifest as reluctance or blocking. Questions will be answered with “I don’t know”, “Nothing matters”, “I don’t have any values”, “I don’t see the point”, “I don’t deserve to have a life”, “This is so corny” etc. Fusion would be manifest as extreme guilt over past failings and hopelessness about the possibility of redemption. If a client demonstrates these responses when you suggest or begin to talk about value clarification it is best to return to defusion and acceptance.
Lack of familiarity with values - Some people who have lived a deprived or impoverished life, particularly those who have been neglected or abused, simply do not know what values are. A technique that can help here is to simply provide clients with a list of 30 common values and ask them to check the ones that resonate for them.
Confusion with goals - Because many people confuse values and goals, it is useful to know how to work to values from goal statements. As an example, clients may talk in terms of the type of partner or job or body that he or she wants to have and the things they want from others such as friendship, love and forgiveness. Some people want fame, wealth, status, respect or success. Emotional goals are very common such as to feel happy, or to have more self-confidence. Dead person’s goals are very common: to not use drugs, to not have panic attacks, to never lose ones temper, to not feel guilty or angry (Harris, 2009; p204). To move from these sorts of goals to values Harris suggests any of the following questions, prefaced by the phrase “If this goal were achieved …”:
- What would you do differently?
- How would you act differently?
- How would you behave differently in your relationships, work life, social life, family life and so on?
- What personal qualities or strengths would it demonstrate?
- What would it show that you stand for?
- What would it enable you to do that is meaningful and that matters in the big picture.
Negative goals – If a client’s goal is for something to end or to stop, we can turn this around by asking what they would want instead: In response to “I want to stop fighting with Mum” you could ask “How would you like to be with your mum? What do you want to do when you are with her?”
When the goal is to change others – If a client says “I want my girlfriend/boyfriend/mother/teacher to be more cheerful/cooperative/friendly/loving/respectful” etc or “less abusive/lazy/competitive” and so on, we might ask “Let’s assume I have a magic wand and I can instantly change this person to fit your ideal. If you did have that ideal relationship, how would you act differently? What personal qualities and strengths would you like to develop or bring into that relationship? What sort of boyfriend/girlfriend/son/daughter/student would you like to be? How would you ideally treat the other person?"