Appendix Table 1: ACT group protocol: Contents per session.

Session

Core process

Goal

During session

Homework

1

Experiental avoidance &

Creative hopelessness

Identify unworkable behavior: behavior that is not moving towards the participant’s values.

Identify that control is not the solution but the problem.

 

Meeting each other.

Exercise: dealing with unpleasant experiences; the costs of avoidance worksheet*

Metaphor: the unwelcome party guest (Aunt Ida) & The monster and the ravine

Poem by Mary Oliver; the journey#

Exercise: dealing with unpleasant experiences.

Exercise: Chinese finger trap.

Put the drawing of the monster and the ravine on your fridge.

Reading handout; handling your homework.

Reading; introduction, Chapters 1 and 2 of The Happiness Trap

2

Acceptance, Willingness & Contact with the here and now

Identify that control is not the solution but the problem.

Exploring the willingness to face your own fears, emotional pain, negative thoughts.

Introduction the human condition.

Introduction to mindfulness.

Discussing homework, including

Metaphor: The monster and the ravine

Discussing acceptance: the difference between pain and contaminated pain/pain and suffering*.

Eating with awareness (the raisin-exercise#), including inquiry.

Sitting meditation with attention on breathing, noises and thoughts.

Doing a daily activity, such as brushing your teeth or having a shower with awareness and full engagement with all the five senses.

Reading handout; mindfulness*

Reading Chapters 3, 10, 11 and 12 of The Happiness Trap

3

Contact with the here and now & Values

Bringing full awareness to your here and now experiences

Introduction to values; clarifying what is most important, significant and meaningful.

Discussing homework

Education about values and the difference with goals.

Filling in the Value Questionnaire * and the Actually-questionnaire*.

Story; The king who had three sons#

Doing another daily activity, such as brushing your teeth or having a shower with awareness and full engagement with all the five senses.

Reading Chapters 24 and 25  of The Happiness Trap.

Filling in the  Bull’s Eye (Chapter 25).

Which value(s) needs more attention in our life?

4

Values & Defusion

Learning to perceive thoughts, images and other cognitions as what they are: nothing more than bits of language, words and pictures instead of rules and facts.

Discussing homework with attention on fusion.

Teaching about the power of language and doing defusion exercises; thinking about a Napoleon boiled sweet.

Introducing the mind of the therapist.

Practice at home with defusion and inventing a name for your mind.

Reading Chapters 4, 5 and 6 of The Happiness Trap.

5

Defusion & Contact with the Here and Now

See session 4 and bringing full awareness to your here and now experiences

 

Discussing homework and experiences with defusion at home.

The participants introduce their mind.

Metaphors: your mind as storyteller and staying behind the waterfall.

Body scan exercise,  inquiry and teaching.

Doing the body scan exercise* 3 times a week Reading Chapters 7, 8, 9, 10 of The Happiness Trap.

 

6

Self as Context

 

Taking perspective and assessing a transcendent sense of self; a continuity of consciousness that is ever present, unchanging and impervious to harm.

Discussing homework with attention for obstacles during mindfulness.

Introducing the observing self during a mindfulness exercise

Exercise; experiencing the observing self

Metaphors; chessboard and sky

Re-evaluation of values  using your Value Questionnaire or Bull’s Eye.

Exercises*: with yourself through time, I am, Rules versus reality

Reading handout: affair “stroopwafel” * (about changing the perspective).

Reading Chapters 15, 16, 17 of The Happiness Trap.

7

Values

Further clarifying values; towards a rich, meaningful life; life from your heart and not your mind.

 

Discussing homework:

What would you do if you had no fears or doubts? What would you do with 50 million?

Participants discuss their personal values, with attention for fusion and willingness to experience unpleasant feelings.

Reading Chapters 26, 27 and 30 of The Happiness Trap.

Making an action plan for one of your values with the goalsetting worksheet in Chapter 27.

 

8

Commitment: Action and evaluation

Setting goals guided by your values and taking action to achieve them.

Discussing homework and formulating committed actions.

Evaluating and discussing personal focus of the six core processes in the future

Goodbye and final meditation.

 

*Exercises and handouts are available in Dutch (Link); #poem, story and exercise in Dutch, translation of Segal MBCT protocol.