Joan Rullan: «More and more people are beginning to train in ACT»

Third generation therapies are part of a wave of recent therapeutic proposals increasingly used by psychologists.

Of all of them, Acceptance and Commitment Therapy (or ACT, from "Acceptance and Commitment Therapy") is possibly the best known, both in relation to the investigations carried out on its forms of application and effects and in relation to the degree of familiarity that psychologists have with it. And this popularity is on the rise.

However, in Spain there is still not a wide variety of specialized ACT training programs. Today We interviewed one of the psychologists who are making sure this changes, Joan Rullan, from Activital Psicólogos.

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Interview with Joan Rullan: training psychologists in Acceptance and Commitment Therapy

Joan Rullan is a psychologist and trainer, member of Activital Psicólogos. In this interview he tells us about the initiative that has led his team and himself to offer training for psychologists and psychiatrists through of Activital's "Acceptance and Commitment Therapy Online Course", one of the few ambitious online training programs on ACT in Spain.

What are some of the myths that exist about Acceptance and Commitment Therapy?

I believe that both Acceptance and Commitment Therapy and Contextual Therapies as a whole are awakening the interest and respect of a good part of the psychologists who come to know them. In this I consider that the scientific rigor of the main ACT developers and the empirical evidence on which it is based have a lot to do with it.

It is true that there are certain myths and criticisms of ACT, which from our point of view are the result of ignorance, or biased information. I have heard, for example, that ACT is practically synonymous with Mindfulness. At ACT we apply certain Mindfulness practices with certain objectives, but it is neither necessary, nor much less a theoretical pillar on which it is based.

In our culture the term "acceptance" can be confused with "resignation", which in many Sometimes it can lead to misinterpretations of what we do in Acceptance Therapy and Commitment.

I have heard other critical opinions that are curiously opposed to each other: since it does not contribute anything new about the radical behaviorism of Skinner, until in ACT emotions and thoughts are considered as causes of the conduct. I do not believe that either of the two positions fits what is exposed in the main texts and training in ACT.

What led you to consider launching the ACT course that you offer at Activital?

The idea came after the ACBS (Association for Contextual Behavioral Science) World Congress in 2017. Speaking with other colleagues, we were surprised to learn that in Spain we were very lucky to have masters exclusively on Contextual Therapies like the one directed by Carmen Luciano. We saw that as her students, we had a broad and deep training.

In many countries the training offer is scarce, and certainly much shorter. One-off seminars are usually held, or they occupy a few hours in general clinical training.

Despite this, we realized that there were practically only two ways to learn ACT in Spain. The first is reading manuals in a self-taught way, and the second in master's degrees like the one mentioned above, but which require a high time and financial commitment. It is true that in some universities some time is being devoted to Acceptance and Commitment Therapy, but in an introductory way.

Our idea was to create an intermediate step, an online course with which to learn ACT in a complete way from the theoretical and philosophical bases to the applied part. That could be useful for those who want to start from scratch, or who have been training in short seminars or on their own for a while.

What are the most important aspects to take into account if, as psychologists, we want to train in Acceptance and Commitment Therapy?

The main thing is that the training emphasizes the theoretical foundations. ACT is a way of putting into practice a set of specific scientific and philosophical principles. Without knowing well functional contextualism and learning principles, we will hardly be doing ACT, no matter how many metaphors we know.

To put a metaphor since I mention them, if we want to learn to play the guitar really well and flexibly in many contexts, we cannot do it by learning the chords of our song favorite. We need to know the instrument well, know about the basic musical principles, harmony, rhythm, and so on.

I also see that since ACT is a relatively new therapy, there are many trainings on "modern therapies", in those that ACT is taught one day and the next another therapy with which it shares practically nothing in its fundamentals. From my point of view, a good training in ACT should be exclusive to ACT or together with Therapies Contextual with which it shares foundations, otherwise we will hardly learn well the model that underlies.

What are the practical effects of trying to apply ACT without having a good understanding of its theory and the philosophical foundations on which it is based?

I think that we will hardly be doing ACT without mastering those bases, given that our social context and cultural when talking about the psychological is very marked by psychoanalysis and the biomedical model.

All people, psychologists and non-psychologists, have our own philosophy, whether explicit or not. Either you are a mentalist or you are not, there is no other. Either you are a mechanist, or a contextualist, a structuralist or a functionalist, and so on.

One of the great advantages of training in ACT is that it invites you to adopt a concrete vision of how how people function, how they are generated, maintained, and can be modified, problems psychological. The applied part is a way to operationalize that knowledge.

Without mastering these bases, it is very easy for us to fall over and over again in that way of talking about the psychological that we have inevitably learned and from which we want to get our patients out.

An example of this would be telling a patient that we are going to help him accept negative thoughts from her. Without wanting to or realizing it, talking about negative thoughts already has aversive functions, and how are you going to accept them, if they are negative.

Following the example, if we have learned ACT only for its applied part, perhaps we will do an exercise to help you defuse from certain thoughts, and at another time in therapy we will try to reduce or eliminate these thoughts. Ultimately, we can create a lot of confusion and be counterproductive with our patients.

I think you can be very eclectic in terms of techniques if you have a solid theoretical base, but being eclectic in terms of fundamentals seems unstable to me, it can be chaos.

What learning strategies and methods have you wanted to promote, considering that they are well adapted to the purpose and content of the course?

The idea of ​​the online course is that it can be comfortable to learn its contents. That is why we allow each student to travel this learning path at his own pace. All modules have a “notes” document, and a video-recorded class on the syllabus, which are uploaded to the platform and are accessible at any time.

As you may have deduced from the previous questions, we dedicated an important part of the training to understanding the Philosophical and theoretical bases of ACT: Functional Contextualism, Behavior Analysis, Frame Theory Relational ...

But it is not a theoretical course; the practical part, seeing how ACT is applied to different problems takes up more than half of the training. In these applied modules, we expose what to do, and how to do it, for which we support ourselves with role-playing videos addressing different problems. So that students can practice, we give them a package with 40 experiential exercises, metaphors and other techniques, and 4 fictitious cases with which we ask some practical questions.

What are the elements of the training that you notice that the students value the most?

We like to have fluid communication with our students, and from what they tell us, I would highlight two elements. The first, the role-playing videos in which they can observe how to carry out the applied part. It is something that we wanted to include yes or yes since modeling learning in therapy has seemed very useful when we have also trained.

The second is individualized feedback. We propose a series of tasks to see how they would approach one case or another, and then we return it to them with comments, and proposals of how the interactions they have raised could be optimized.

Have you noticed changes in the way psychologists in the Spanish environment perceive and use Acceptance and Commitment Therapy?

Without a doubt, I think it is a reality that more and more people are beginning to train in ACT, and I think it is important to emphasize that they stay in ACT. And psychologists look for what works best for us in therapy, so the fact that they “stay” on ACT is a sign that they find it useful in helping their patients.

I know that the contextual model is increasingly entering universities in the country, especially in Andalusia. We ourselves, being a small team, have trained more than 200 professionals in the two years that we have been offering the course. We have several very complete master's degrees in Spain from which people leave, as far as I know, learning a lot and with a clear model.

I would also like to highlight something interesting that some students have shared with us, and it is how through training in ACT, they have known the behaviorism firsthand, reading Skinner, for example, and have been amazed at how different it is to what they were told about behaviorism in the race. This change in perception seems very interesting and promising for the future of our discipline and the development of psychology as a science.

This is something that I think affects both behaviorism and Contextual Therapies. It gives me the feeling that today there are so many therapies, pseudo-therapies and others, that psychologists have to choose and choose well. And if you start to investigate currents and models, you see that ACT has the scientific character and commitment for the research that I think should be required of any psychological perspective, and that generates confidence.