Psychother Psychosom Med Psychol 2017; 67(12): 525-536
DOI: 10.1055/s-0043-118742
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© Georg Thieme Verlag KG Stuttgart · New York

Akzeptanz- und Commitmenttherapie bei chronischen körperlichen Erkrankungen

Acceptance and Commitment Therapy in the Treatment of Chronic Disease
Katharina Kuba
,
Gregor Weißflog
Further Information

Publication History

Publication Date:
13 December 2017 (online)

Preview

Dieser Beitrag stellt das Hexaflex-Modell der Akzeptanz- und Commitmenttherapie (ACT), die dazugehörigen Kernprozesse sowie eine ACT-Gruppenintervention für chronisch erkrankte Patienten vor. Zur Verdeutlichung der Kernprozesse haben wir jeweils exemplarisch eine Metapher vorgestellt. Diese Metaphern sollen den Klienten potentielle Handlungs- und Denkalternativen in ihrer aktuellen (Erkrankungs-)Situation aufzeigen.

Abstract

Acceptance and Commitment Therapy (ACT) is an intervention representing a transdiagnostic and contextual approach that assumes that psychological suffering is caused by experiential avoidance. The primary intention of ACT is not to eliminate symptoms and to treat mental disorders. Instead, ACT aims to increase psychological flexibility, i. e. to broaden the repertoire of cognitions and behaviors when facing inner and outer aversive events or experiences. Psychological flexibility can be enhanced by working with the 6 core components of the ACT model. Experience-focused methods like metaphors and exercises for acceptance play a crucial role in the therapeutic work. In short, with ACT patients can learn:

▪ that rigid and inflexible attempts to fight aversive experience are problematic
▪ a mindful experience of inner and outer experience
▪ to differentiate between unchangeable and changeable events (acceptance)
▪ to identify values or respectively life goals and to behave in a way that is consistent with them (commitment)

The therapeutic focus of ACT is to create a balance between acceptance and behavioral change consistent with chosen values. Chronic diseases are often associated with aversive inner and outer experiences. A growing number of studies support the efficacy of ACT. There is evidence that ACT can increase psychological flexibility and potentially also lead to better self-management within the context of chronic somatic diseases.