How to build meaning through values work in therapy?

In the past decade, I’ve been lucky enough to meet all kinds of mental health practitioners from all over the world as I led clinical trainings. I’ve been excited, inspired, challenged, and often surprised. Working with different cultures and institutions, I naturally witnessed a variety of reactions to the materials I was teaching. But there is one thing that I saw in every workshop: smiles on the faces of participants when we talk about values.

Originally trained in traditional CBT, I learned strategies to reduce problematic behaviors and painful psychological experiences. It was only when I began to read about contextual CBT (see Hayes et al. 2011) that I learned about values in therapy. To be honest, my first reaction was suspicion! I was afraid the word implied some sort of morals that clients were encouraged to adopt. However, as a Frenchman exposed as early as junior high school to existentialist philosophers like Camus and Sartre, the idea of helping clients build meaningful lives was particularly appealing. But my rational mind was also asking for a solid scientific account of values, and for some evidence-based guideline to working with this process in therapy.

Fortunately, excellent theoretical and scientific work done on values in contextual behavioral science (CBS), and more specifically in relational frame theory (RFT) (Plumb et al., 2009), shows fascinating applications in therapy (Dahl et al. 2009). In this approach, values are defined as inexhaustible sources of satisfaction, broad enough to include a variety of actions and goals, formulated as positive rather than negative reinforcement to encourage growth rather than relief, and intrinsic enough to be independent of external outcomes, such as social approval.

When we first ask our clients what they care about in their lives, they are generally so focused on what they don’t want and what they are supposed to want, that they often find this topic painful or flavorless. But as we help them redirect their attention toward positive, broad, and intrinsic sources of satisfaction, they begin to smile. In a chapter of a book I co-authored with Jennifer Villatte and Steven Hayes, Mastering the Clinical Conversation: Language as Intervention (in press), we used RFT and CBS principles to identify what therapists can do through natural conversations to help clients clarify and build values. You can see an example of interaction using these principles in this video taken from an on-demand course on values available here on PracticeGround.org.

In April, I will help Kelly Koerner begin a special course on values (which includes free access to my Values On Demand course). 100 days will be devoted to building competence with values work: just like an athlete or musician, by deliberately practicing a small set of key interventions, you will build the expertise to move session level outcomes, and doing interventions consistently well will become a habit integrated into your routine. Join us for a fun challenge! Registration and further information on the Values Challenge and two other 100-Day Challenges, Compassion Focused Therapy with Russell Kolts, and Treatment of Shame with Jason Luoma) is available here.  Registration for the Values Challenge, as well as the full series that includes all 3 challenges in one reduced price package closes on April 22nd, so reserve your spot now!

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., Villatte, M., Levin, M. & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141-168.

Plumb, J. C., Stewart, I., Dahl, J., & Lundgren, T. (2009). In search of meaning: Values in modern clinical behavior analysis. The Behavior Analyst, 32, 85-103.

Villatte, M., Villatte, J. L., & Hayes, S. C. (in press). Mastering the Clinical Conversation: Language as Intervention. New York:  Guilford Press.