The Meaning of Experiential Practice

One of the most emblematic terms of 3rd wave CBT and mindfulness-based therapies is “experiential”. It was even in the subtitle of the first manual of Acceptance and Commitment Therapy – ACT (Hayes, Strosahl, & Wilson, 1999). Many workshops for therapists are now labeled “experiential” to emphasize that the training won’t (only) be didactic, but that the trainees will have opportunities to try techniques that clients do for themselves and practice what they will do as therapists. As often happens when a word becomes popular, though, its meaning has perhaps become less clear, or even the opposite of its original meaning (did you know “awful” originally meant “inspires awe”?).

What does experiential mean? Does it mean that instead of listening to a lecture, we practice skills? Does it mean that we contact experiences that make us feel emotions? Does it mean that we discover something new?

In my area of expertise, Relational Frame Theory– RFT (a model of language and cognition that underlies ACT), we approach experiential practice as a way of learning by contacting contingencies rather than by listening to descriptions of contingencies. In other words, we learn by observing antecedents, actions, and consequences, rather than through rules that tell us what to do and what to expect from our actions.

It’s not about feeling vs. analyzing. It’s not about doing exercises vs. talking. It’s about getting in touch with one’s own experience and noticing the impact of our actions. The means are various. We can use formal meditation or mindful talking. We can linger on a sensation without saying anything or we can analyze a behavioral sequence step by step. The point is that we explore and discover on our own what works and what doesn’t work, what brings us closer or farther away from what we care about.

In therapy, using experiential techniques means we don’t tell clients what they should do. We don’t give them answers. We help them find the answers that make sense to them. I hear sometimes that this approach is different than skills training. I would argue that experiential techniques teach a kind of skill. Perhaps the most important one: the skill of observing actions and consequences, of assessing the effectiveness of responses, and of increasing flexibility of responses. It’s a kind of overarching skill, which takes different forms, and applies to a variety of contexts.

Why use experiential practice in therapy? There is some growing evidence that this approach improves outcomes of interventions based solely on providing a rationale (e.g. Levin et al. 2012; McMullen et al. 2008). The aim of experiential practice is to help clients be more autonomous (like teaching how to catch a fish rather than giving a fish), and more flexible (because observation skills apply to any context). Rather than learning a specific skill that works in a given situation, clients learn to be in touch with what matters to them, and to notice moment by moment and over time what works for them.

In the ACT-RFT track I facilitate inside the PracticeGround Learning Community, learning experiential skills is a pivotal aspect of the training. We ground these skills in behavioral principles because we want this work to be tightly linked to evidence based practices. It does entail some didactic work, and this might seem paradoxical given that we distinguish learning through experience from learning through rules. But learning how experiential techniques work through rules explaining key principles is not incompatible with doing good experiential work. In fact, I would argue that it’s quite the opposite.

Here is an example of how using behavioral and RFT principles in training can support the learning of experiential techniques. Perhaps you know the Sweet Spot exercise, one of the most popular ACT exercises. In this exercise, the client is invited to remember a meaningful moment of his life as a way of reconnecting with his values. It’s a classic exercise that most ACT therapists do at some point in training workshops, and use in their clinical practice. It’s relatively easy to conduct the exercise itself (you can use the full script from Mindfulness for Two, Wilson & Dufrene, 2009), but the outcome we expect rarely happens from doing the exercise only. The debriefing is key, because that’s when we can help clients extract a connection between their meaningful memories and a value. This phase of the exercise is a bit more complex than reading the script; it requires therapists to guide clients through a verbal elaboration that conveys the emotional qualities of the special moment of their lives. Learning the principles that underlie this exercise can help therapists avoid the trap of over-explaining, or leaving the client in unnecessary confusion.

I recently shared this video in my ACT-RFT track to demonstrate the debriefing of the Sweet Spot. I play the client, and Jennifer Plumb Vilardaga plays the therapist – she is the co-author of The Art and Science of Valuing in Therapy (Dahl et al. 2009).

You will see captions based on behavioral and RFT principles, which are meant to help trainees recognize the client’s cues and the function of the therapist’s interventions. Just as musicians learn to read music in order to play and write any song they want, therapists can learn the principles that operate at the core of experiential techniques in order to adapt these techniques with flexibility to each client and each situation. Notice how during the first few minutes, the therapist spends some time evoking the observation and description of what the client felt during the exercise. Then, she moves on to the exploration of values connected to the client’s memory. She does so through questions and reformulations that evoke and strengthen “hierarchical framing” (the kind of verbal relation that connects actions to values in ACT-RFT). She also gently orients the client to positive and intrinsic sources of reinforcement when he is over-focused on avoidance and external outcomes. This whole interaction is experiential, according to the definition I proposed earlier, since the therapist only helps the client observe his own experience and draw conclusions, without delivering any kind of rule.

If you are interested in this kind of learning experience, you will certainly like to join our new Learning Community in September. In addition to my ACT-RFT track, there is a DBT track led by Kelly Koerner. Registration is open now and closes on September 10th. Checkout information here.

—Matthieu Villatte, Ph.D.

References

Dahl, J. C., Plumb, J. C., Stewart, I., & Lundgren, T. (2009). The Art and Science of Valuing in Psychotherapy: Helping Clients Discover, Explore, and Commit to Valued Action Using Acceptance and Commitment Therapy. Oakland, CA; New Harbinger Publications, Inc.

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford Press.

Levin, M. E., Hildebrandt, M., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741-756.

McMullen, J., Barnes-Holmes, D., Barnes-Holmes, Y., Stewart, I., Luciano, M. C., & Cochrane, A. (2008). Acceptance versus distraction: Brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks. Behaviour Research & Therapy, 46(1), 122-9.

Wilson, K. G., & DuFrene, T. (2009). Mindfulness for Two: An Acceptance and Commitment Therapy Approach to Mindfulness in Psychotherapy. Oakland, CA: New Harbinger.