For us, being therapists is an absolute privilege.

To join people on their

journey, to be trusted with intimate secrets, to be in a position to help another person
craft a meaningful life, is incredibly satisfying. At the same time, it demands a lot. The
sense of responsibility weighs heavy at times. The desire to help when help can’t be
offered. Needing to be psychologically flexible when sometimes the rest of our lives
doesn’t allow much breathing space.

For those of us who have

that perfectionistic streak (aka - I’m
not good enough/ useless/ terrible -
must work harder, faster, better!)
along with a healthy dose of the
i m p o s t e r s y n d ro m e , b e i n g a
therapist can be a tricky role. Our
ever busy, fixing-addicted minds
love to find things wrong (especially
with us), and what better place to
s t a r t t h a n i n t h e m e s s y,
unpredictable business of therapy!

This book is written from the

perspective of Acceptance and Commitment Therapy (ACT). This just happens to be
the method of therapy we both use. It’s one perspective among many useful ones
available, and we hope it may be of use whatever your professional background.

If you already are an ACT therapist or are on your way, you might have some ideas
of how this “should be” so far.
A better ACT therapist would…

• Be less avoidant
• Be practicing mindfulness at least once a day (probably twice).
• Wouldn’t get so fused with their thoughts Know their values. Work to their
values.
• Not be caught up in self-as-content (or just have a halfway decent
understanding of self as context)
• Be all compassionate, wise and loving to everyone AT ALL TIMES!!

Phew. It’s hard being an ACT (or any other) therapist at times…

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 This e-book is written by the two of us who are ACT psychologists. We are
passionate about our work, love what we do and help make real, genuine changes in
people’s lives. And sometimes we both think we are the worst therapists EVER. We
make mistakes. We screw things up.
And, in our own humanity, we continue with our work. Because it’s important.
Because it matters to us.

In doing this, slowing down and pausing, accepting that this is the case, and
easing up on the desperate struggle for it to be different, we (in that odd, paradoxical
way) can allow for purposeful change to occur. Change that recognises the commonality
in this experience as a therapist. Changes that allow for a mindful acceptance of these
thoughts and feelings. Changes that allow for a deep and healing self-
compassionate stance towards ourselves in this work.

We will go through some basic concepts that come from the Contextual
Science model * itself, and weave this in with our own experience of what we do
when we get lost in session.
This e-book seeks to outline ideas, thoughts and strategies that are personally
helpful to us in our work and we hope it may be helpful to you.

*: If you want to know more about Contextual Behavioural Science and its clinical applications
there are loads of materials and info available, we encourage you to visit the ACBS page or to
get in touch with a good ACT therapist who can give you some advice
(www.contextualscience.org)

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 This is not at all written from a place where we’ve got our sh*t sorted. Nope, not at
all. Turns out we make mistakes and screw things up, say stupid things right up there
with the best of us. And as much as our minds scream at us not to tell you any of this
(“they’ll lose respect for you; what if someone you’re working with read this?!; they will
judge you NEGATIVELY!”. Ahem - thanks mind…), here are our personal Top Stories
that get us stuck when we’re in the therapy room.

Joe’s
You’re not creative/ fun/ engaging/ interesting enough as a therapist.
It’s not enough. You’re not enough.
You don’t know what you’re talking about. You don’t know anything.
You’re lazy – a proper therapist would be doing more.

Helena´s

He does not understand the therapy.

She doesn´t want to change, she will leave.
You don´t know how to continue with the session, this job is
not made for you.
You feel very sick and confused. Stop the session. Go home.

When we decided to write this e-book, we started with a premise: like us, you
are someone who has had such thoughts, or similar ones, over and over again.
You’ve felt lost and confused in session, and you might also have thought that this
means that you are a very bad professional, because “good therapists shouldn´t think/
feel that way!”

Well, if you have all that thoughts, IT IS OK.

We are convinced that having these beliefs does not make you a better or worse
therapist and that having those thoughts and feelings is normal and unavoidable for
anyone and for any psychology professional. For us too!

The reality is that, on a daily basis, many health professionals continue struggling
with all these ideas. Unfortunately, there is still a certain taboo about the issue and there
is not much material out there that addresses the question in a practical, contextual and
applied way for helping us, the therapists.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 While these thoughts and fears may actually be factual, the key is not so much
about the presence of these stories. You guessed it; it’s about how we respond to
these stories when they show up. And that’s what we want to focus on here.

What do we do when we get lost in our thoughts and feelings (some real examples) *:

The client looked across the room at me, over the top of her glasses.
She was dressed in a sharp suit and looked like she had stepped out of a very
high-powered meeting with very high-powered people, which in fact she had
just done.
“You want me
to do what?!” This
was in response to
my suggestion we
do a values exercise,
taking the
perspective of a
retirement party to
reflect on what was
important to the
client. “Ridiculous,
who comes up with
this rubbish?”. “Um,
well, we don’t have
to of course. We can
go back to
debriefing on your
stressful week if you like”.
Meanwhile, my mind kicked into overdrive, reminding me how I could
never offer anything useful to someone so competent. And the anticipated
anxiety of having a frank discussion about therapy interfering behaviours was off
the charts. Better to stay nice and quite. Which was what I did for the rest of
the session.
Joe

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 I remember one of the first sessions I had with a client some months
ago. I was working on the functional behavioural analysis with her and I started
having some thoughts and uncomfortable feelings that told me the client was
not understanding her own inflexibility and experiential avoidance patterns as “it
was supposed to be” (in my mind it usually sounds like "she does not get it, she
doesn´t understand it, I´m failing!”).
By that time I was so full of impatience and frustration…I could feel that
big urge to react, explaining to her about her behaviour patterns and their
consequences essentially me telling her how doing what she did was making
things get worse…
Instead of making certain
therapeutic movements,
asking the right questions,
keep myself quiet and
gently allow her to come
up with her own answers, I
just did what my mind
wanted me to do and told
her, straight away, “you’re
doing this doing wrong”.

I remember me talking a
lot, explaining everything
a b o u t h e r b e h a v i o u r,
about human behaviour…
and I kept asking her again
and again "do you see it? do you get it?", insisting until she, resigned, had to
say "yes ..I get it".
My anxiety and frustration decreased, yes, she said she understood what
was going on, but my interactions as a therapist didn´t help the client to
discriminate her behavioural outcomes by herself. I did what I thought I “had”
to do, not what I really had to do in terms of the client´s needs.

Helena

*We’ve changed some details here to keep things confiden6al.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 So, we´ve told you about some of our own "passengers" (to borrow from our
ever favourite ‘Passengers on the Bus’ metaphor’) - those stories that emerge within the
course of a therapy process, those "mental visitors" that show up in our sessions (and in
our daily life) and how we experience them. We wanted to introduce ourselves with a
big "hello, you are not alone!" But this is not just about sharing our "dark secrets" as
therapists! We are writing this in a way that we hope is useful for you.

We believe that there are a number of basic starting attitudes that could make
a real change in how we relate to our stories and to our work in session. Key ideas
that we apply in our own practice when we lose ourselves and we need to find the
way again. You can use them as “mantras” or easy reminders to be able to come back
to the session. If you really like it, place it in your office or therapy room..

Welcome to our 5 Top Tips section…

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 These top tips are some of our own thoughts and we find useful to hold in mind
and we appreciate you might know these already yourself but nothing like a helpful
reminder, right? Perhaps treat them as gentle suggestions to be held lightly, and not
orders that must be obeyed.

Recognise your own barriers

It’s important for us each to recognize your own barriers that show
up when working with clients. This requires a degree of honesty as we
look in the mirror and notice our faults, flaws and defects. But doing so allows us the
best opportunity to respond most helpfully for our clients and also ourselves. We get to
step out of automatic pilot, where are thoughts and feelings to the driving. By
recognizing your own barriers you place your hands firmly on the wheel and set the
course.

Being willing to notice my own barriers was initially a painful honesty exercise. I
was deeply attached to the belief that the “therapist should have everything
under control”. I kept thinking "I can´t feel any anxiety while seeing a client. I am
the therapist, for God sake!" Since then, I have continued taking further steps in
ACT training and supervision. Noticing what shows up is still painful, but now it
is also a liberating experience. I do not need to hide from what arises, I just can
notice it and keep on working. Meanwhile, I still hear some stories from
colleagues who claim not to feel or suffer while in session...

Helena

Be kind to yourself

Of course doing the above is likely to be more successful if we treat ourselves

with the big old dose of kindness. Recognising our barriers doesn’t mean we need to
beat ourselves over the head with them. Perhaps as you meet your own barriers that
you don’t start a battle against them, nor yourself for having them. Just simply that we
approach them with honesty and a degree of warmth. Self-care is meant for you too.

I’m not going to pretend I’ve personally got this self-compassion business
nailed down. Far from it. My favourite go to strategy is to worry things going
horribly and terribly wrong. And hands up, it’s not like I don’t get something
out of all this worry. I get stuff done, I’m organised, I plan – and there’s no
doubt that I worry that if I don’t ceaselessly worry, I’ll somehow need to let go

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 of this. For me, being kind is hard. But deeply helpful. It’s not a feeling– it’s a
stance I take with myself that’s an action. At its heart it boils down to a message
that’s something like “It’s OK, Joe, you can trust yourself that you’ve got this
one.” This allows me to slow down, not drive myself so hard and let things fall
into accord as they will.

Joe

Common humanity

One of the key ingredients for kindness is the recognition that we are not in this
all alone. It can feel at times like a lonely journey, so much more so when we believe we
are the only one who struggle with barriers. It easy to look around friends and
colleagues believe them to be successfully striding through their professional lives with
grace and confidence. As we pause carefully and mindfully look around, it’s useful to
catch this as a story and remember that chances are others are struggling at times, just
as we sometimes do.
One of the things we love about being ACT psychologists is that
our community supports us to openly share our own stuff, as we
are doing now with you. Knowing we all struggle sometimes and
getting to talk about it really helps and makes us feel
emotionally supported and connected. Our aim is take this
further though. It is not just about what we feel as individual
therapists; it is also about what we do outside the context of therapy so we can look
for solutions together, as a community of practitioners.

Continue Learning

Of course, just by recognizing the fact that we all screw up at times, doesn’t get
us off the hook for continuing this learning journey. There will be plenty of opportunity
to update our knowledge, build our skills, continue to practice, or get supervision by
people further down the journey than us. And this is a wonderful thing.
The day you think you’ve reached the end of the journey, is probably
the day that it’s time to hang up your hat and think about retiring.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
Be grateful

It’s important to bring a flavour and feel of gratefulness to your barriers.

Your fears, worries, anxieties, doubt are easy to treat these as the enemy. In
fact very often it’s the opposite that is the case. These so-called flaws are
the very thing that allows us to connect deeply with our clients. They are a
product of the inevitable uncertainty of therapy work. Or are genuine
reflections of the fact that you’re not yet at the end of the road. Admittedly barriers are
not always easy to welcome but it’s useful to mindfully reflect on what they do bring to
the work and take a stance on gratefulness towards them.

In session

Here are three things we believe are super helpful for each of us to remember
just at the moment before we enter into a session. We can remind ourselves to pause
and notice whatever it is the shows up. We can take a stance of accepting the stuff
that arrives. And lastly as we pull out our values compass, we can remind ourselves
what in fact we would like to take action towards and make a small commitment to
take steps in that direction.

Write these on your diary, on your screen saver or get a tattoo! Three simple
things to remind yourself of:

Notice
Accept
Commit

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 Open, aware and willing to meet your own barriers

Research shows that 90% of our fears and anxieties about being therapists have
to do with two major concerns: the “lack of skills” worry and the “lack of
knowledge” worry (and by research we mean a survey N = 2. But you get the point).
Often, these concerns are products of our self-stories busily whirring away, and we can
do well to simply notice it as that.

But of course, sometimes, these concerns are legitimate! The fear of not
knowing where to start a piece of work, not knowing what to do or having no idea on
how to proceed is a very sensible sign to say more learning is needed. It could be
pointing us down a new ACT path: to seek out specific theoretical knowledge, applied
and experiential training, experience with clients and supervision.

I moved away from psychology for a few years because I felt I had no
idea how to act in front of a client, and I did not know anything! In my case, all
those fears and insecurities worked as a red traffic light that was telling me "do
not do what you don´t know how to do".
After a few years away from the world of psychology and psychological
therapy, and thanks to being an ACT therapy client, I realised that my true
vocation still was to become a therapist. All those fears and doubts continued
there with me (talking loud!) but I learned how to take some action and do
what I needed in order to be a therapist. I looked for the best ACT training
available in my country and, after almost two years of study and practice, I knew
I was ready to start, even though my mind has never stopped telling me that I
am a disaster ever since. The difference is not whether my mind has stopped
telling me stories, or not, but what I have done to get to the point where I
am now. And what I need to keep doing.
Helena

Our happy feel-good society invites

us most of the time slap a smile on our
face, act like we’re in control, pretend we
do not feel anything "negative" and hiding
it from clients, colleagues and, sadly, to
ourselves. As the verbal context tells us "a
vulnerable and fearful psychologist can´t be
a good psychologist" we spend our days
trying to prevent any hint of insecurity or
fear by multiple mechanisms, all this
seasoned with big doses of self-criticism
and frustration.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 I originally trained as a cognitive behavioural therapist (heavy on the ‘C’;
light on the ‘B’) and moved gradually into using ACT. After a number of years
using ACT, I was struggling to flexible adapt ACT techniques, particularly
with complex clients. I would get anxious and stressed that I wasn’t able to
effectively formulate with clients and properly unpack issues.
The “I’m a rubbish therapist” story was louder than ever. Eventually, I
realized that as much as I needed to hold that story lightly and be kind to
myself, I also needed to go back to basics and learn behavioural principles and
how they could be integrated with ACT. This meant lots of reading along with
tough specialist supervision that I found very challenging. For months I felt like I
did when I was a trainee psychologist – lots of anxiety and worries. But
gradually things settled into place and the new skills and knowledge came
online. This isn’t to say the “I’m a rubbish therapist” stories have disappeared
but my relationship to it has changed a lot. I was glad I was able to listen with
kindness beyond the story, and recognize the call to action.
Joe

Many therapists will spend a lifetime hiding their fears in session, to others, and
to themselves (pretending to know how to do everything well in front of others, not
letting others see their work, or going from here to there in sessions just reacting to
their barriers). But there is another pathway available, which invites us to respond
differently. The driving force for the second road, curved but much more
meaningful, is the values structure that, as therapists, is guiding our own itinerary.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 Given the many emotional states we "navigate" in session with our clients,
contextual therapists have the extraordinary opportunity to apply the model’s main
therapeutic principles in our own life. Of course, with healthy doses of compassion
and acceptance and doing our best not to beat ourselves over the head with our
values.

Possibly, many of you are already familiar with the Psychological Flexibility
concept and its popular hexagon: the Hexaflex. Certainly, the psychological flexibility
model is the essential framework through which we understand the nature of clients’
interactions within their context, and beyond, there is also an interesting parallelism
with the main psychological processes present in the course of a therapy, so we have
adapted and related it to the therapeutic process in a simple and visual way as you´ll
see below.

These are equivalent processes that need to

be thought through, that of the client and
that of the therapist. A values focused
learning, the acceptance of private events
and the development of new, more flexible
behaviour repertoires.

With the help of the model´s main features

and with good practical training and
supervision, we can learn how to come back
to session with the client´s needs at the
forefront. And in a way to make sure we
don´t get lost in a sea of anxiety, insecurity
or shame driven action.

Basic behaviour principles (behaviour

analysis; relational frame theory) give us a
method when we go into the therapy
“kitchen” – they help us develop good
recipes and pick the best utensils for the dish. They help us to be experimental and
creative in how we mix together key ingredients to get the bet outcome in our clients’
lives.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 If you want to understand more about it and learn how to use it on your
sessions, you can find some good Relational Frame Theory (RFT) material on the ACBS
website. Also, if you can get to a good workshop, it´ll worth your time and the effort!

We also love how Functional Analytic Psychotherapy (FAP) approaches all these
processes and meaningful client - therapist interactions. The development of deep,
strong therapeutic relationships is one of the most powerful challenges we face as
therapists (don´t miss the chance of finding out more of what Mavis Tsai and Bob
Kohlenberg and their team have - and still are - showing us about this issue).

Here are some infographics made for you to better understand how you can
use the Hexaflex principles to your own practice as a therapist, we hope you find it
useful.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 We believe contextual behavioural science needs to progress by evidence
based knowledge, from basic and applied research. We also need cool, simple and
comprehensive materials to use on a daily basis within our clinical settings. This is the
aim of this e-book: bridging theory and reality from our experiences. Our career as
psychologists and therapists is exciting and challenging, however, our experience is that
we spend much of our time trying to become reliable, effective and helpful therapist for
our clients, but sometimes we overlook our own self-care needs. It´s hard to be there for
others when we are not there for ourselves too.

We hope you won’t take these words as factual statements or obligations of any
kind - we wouldn’t like to be that kind of person to you. We just know that we do not
yet have a lot of material that supports us, as therapists. So we wanted to contribute
with some brief and inspiring ideas to help you approach your sessions with some more
perspective, whether you are a beginner or an experienced therapist.

There is still much to be done on understanding the therapist's barriers.

Research on contextual therapy approaches has come a long way in the last ten years,
but we still need to know more
about the mechanisms that
underlies the therapeutic process
from the therapist’s perspective.
Some professionals have already
started working it out and we are
closely following the advances of
many colleagues who are sharing
their findings and reflections on this
topic through basic and applied
research, conferences, workshops,
free resources, books, guides,
protocols, etc.

Thanks to all those colleagues with whom we have shared ideas, and have
worked with through these years - they keep us motivated and supported. Being aware
of your own barriers can be tough but sharing it with others can make it meaningful. We
are committed to the advance of our profession through learning, practice and sharing
knowledge. This is why we are proud to be part of this big ACBS community that
embraces curiosity, life-long learning and support between us.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018
 A big thank you to all the people who have shared knowledge and
experiences with us by many different ways thought all that years. Thank you all of
them because they first built the "bus" we are driving as therapists and many others
keep making engineering works for a wider, stronger "highway" with their contributions.
Thanks to our professors Carmen Luciano and Marisa Paez, Steven Hayes, Kelly Wilson,
Yvonne and Dermot Barnes-Holmes, Jason Luoma, Russ Harris, Bob Kohlenberg and
Mavis Tsai. Thanks to Maria Fornet (www.mariafornet.com), writer, blogger and
psychologist, and Marina Díaz, from the blog Psicosupervivencia
(www.psicosupervivencia.com), because their blogs are inspiring and fresh.
And a big thanks to our clients because they choose and trust in us as
engineers of their buses too.

There will be a “The ACT Therapist Guide to Self-care. Part II” with more tips
and worksheets. We would love to hear your opinions and to know what you would
like to read in further therapist ebooks, we are open to suggestions, ideas and
discussion.

THE ACT THERAPIST GUIDE TO SELF-CARE. © HELENA COLODRO & JOE OLIVER 2018