Everyday life is full of challenges and situations that are beyond our control, and that sometimes makes us angry. For a child on the autism spectrum, however, feelings of frustration or anger that can surface from these everyday hiccups may become overwhelming.
At Gateway Pediatric Therapy, which services seven locations in southeast Michigan, board-certified behavior analysts work with children and teens to reframe thoughts that lead to anger or frustration for healthier outcomes using a technique called acceptance and commitment therapy (ACT).
“Through ACT, we try to teach the client ways to accept that this pain or frustration is a present part of their life, rather than allow it to dictate how they respond or how they live their lives,” explains Jake Boehm, board-certified behavior analyst and Assistant Clinical Director at Gateway Pediatric Therapy in Sterling Heights. “This therapy teaches clients to engage in a committed action in service to things they value in life.”
Using ACT, a board-certified behavior analyst will implement strategies to help a client build skills that direct their behavior toward positive outcomes. These strategies include recognizing what a client values and identifying actions or behavior that will best align with those values.
Establishing a framework for awareness
In practice, Boehm first works with a client to identify their values, since a part of ACT is about steering behavior towards the individual’s desires.
“For a 10-year-old, their values are not health or nutrition or world peace. But it might be playing video games. That’s fine, because we can work within this framework to establish the concept and then broaden it,” Boehm explains. “When working with a child, it’s important to break it down to a metaphor they would understand.”
If he knows that a client really loves having parties, Boehm will ask that child to imagine a party with all of their favorite people, games and food. “But I ask them to recognize that there will also be a person they don’t like at the party. Will the child stand at the front door and try to prevent that person from entering, but end up missing the party altogether? Or will they enjoy the party despite this person being there?”
In essence, Boehm uses ACT to help clients recognize how to make room for negative feelings — the metaphor of the disliked person at the party — rather than ignore them, become overwhelmed by them or let them interfere with normal functioning.
“This brings in the concept of defusion, which is looking at our thoughts versus from our thoughts. It’s looking at a thought for what it is, which is a series of words,” Boehm says. “Defusion ultimately helps a client separate themselves from the thoughts they have created.”
Mindfulness techniques, which encourage individuals to focus on the present moment, rather than on the past or the future, can play a role in ACT, Boehm says. Through mindfulness, we can learn to accept our feelings and find ways to live in harmony with them.
Making space for feelings and letting them pass
Unlike other talk-based therapies, ACT is based on observable actions, which means results of the therapy can be seen through behavior, says Boehm.
“What’s great about ACT is that we, as practitioners, can use this therapy to encourage clients to actively engage in behavior that we can see — and observe them adopting behaviors to better their lives,” he says.
“I recall a client getting visibly upset and his parent asked what he needed. He said he didn’t need anything, and that he was just upset. He labeled his feelings without engaging in maladaptive behavior, and he let the moment pass. It’s rewarding to watch these concepts be put into motion.”