Avoiding the pitfall of focusing on form versus function while in session

By Darrah Westrup, PhD and M. Joann Wright, PhD

One of the challenges therapists face is to avoid getting stuck in form instead of working with function. This is an essential component of doing acceptance and commitment therapy (ACT). When you approach your clients from the content (form) level, you are problem solving, or following the story of your clients. This is opposed to what we suggest in ACT, which is to approach your sessions by honing in on process or function. Minds typically attend to content; as a result, it’s easy to be pulled into it. Think about how often a client hooks you into tête-à-tête. For example, if a client says “I’m worthless,” it’s easy to join in and respond based on the content of those words, and spend time discussing, disputing, or rescuing. Instead, we want to discover how that thought influences the client’s behavior: the function. Let’s look at the difference:

Content:

Client: “I had another bad blind date. There’s no one out there for me.”

Therapist: “I’m sure you’ll find someone. What went wrong?”

In an effort to help the client feel validated and hopeful, the therapist chased down the content. This can create more fusion and “stuckness.” Instead, by investigating the function of the client’s words, the therapist can theorize that their comment suggested an attachment to their conceptualized self—a fusion to rules about what dates should be—and offer ways to defuse and contact the observer self (self-as-context).

Process:

Client: “I had another bad blind date. There’s no one out there for me.”

Therapist: “You’re thinking that there is no one out there for you?”

Here, the therapist is eliciting defusion and contact with the observer self. This allows the client to become unglued from their thought and move through it. Choosing function over form can really add power to your therapeutic process.

Darrah Westrup, PhD, is a licensed clinical psychologist with an established reputation for her work as a therapist, program director, trainer, researcher, and consultant. She is author of Advanced Acceptance and Commitment Therapy.

M. Joann Wright, PhD, is currently director of clinical training and anxiety services at Linden Oaks Behavioral Health at Edward Hospital in Naperville, IL. She is dedicated to teaching and delivering ACT in order to help people reduce the suffering in their lives.