Reboot West: Using Acceptance and Commitment Therapy

Using Acceptance and Commitment Therapy (ACT) to help care leavers progress in education, training and employment (EET)

What is ACT?

Acceptance and Commitment Therapy (ACT) is a psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility. The notion of psychological flexibility is about being able to stay in contact with the present moment regardless of unpleasant thoughts, feelings or bodily sensations, while choosing behaviour and action based on the situation and personal values. ACT gives insight into how language entangles people into futile attempts to wage war against their own inner lives. It helps people learn how to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. This helps them gain the skills to recontextualize and accept these private events, develop greater clarity about personal values, and commit to needed behaviour change.[1]

We use a model of ACT called DNA-V developed specifically for working with adolescents. DNA-V was developed by the Australian clinical psychologists Louise Hayes and Joseph Ciarrochi.[2]

What is Reboot West?

This is a four-year programme, funded by the DfE, working with care leavers aged 16-25 to get them into education, employment and training as well as helping them to achieve stability and well-being in their lives. A team of nine Coaches work across four local authorities, co-located in their offices and embedded in their care leaver (or throughcare) teams. Coaches have relatively high caseloads, of 28 young people each, but are able to work with them for up to four years and develop strong relationships over that period. The care leavers we work are either NEET (not in education, employment or training) or at risk of NEET and some have complex needs and are living in challenging circumstances.

How Reboot West helps young people progress in EET

Reboot West aims to support the young people we work with to try new things and learn from them. By learning from our experiences, be it success or failure, we gain value, and when we live a life with value, we thrive.

We all start life as explorers: with little experience of the world, we rely on our care givers (parents mostly) to advise us and keep us safe and overtime we discover through play, trial and error. As we become more independent, we learn from our experiences and we rely on our own internal advice; “Don’t go over there, it’s dark,” “Do eat that sweet, it tastes nice”. These thoughts become the drivers of our behaviour, some of them are helpful and keep us safe but some of them trap us, judge us and ultimately limit us.

Many young people leaving care have not had consistently safe advice and guidance from their care givers and much of their experience of trial and error has led them to harm or trauma. So, it’s unsurprising that many of the young people we work with avoid risk or even any new experiences.

Reboot West uses mindfulness techniques to support young people to notice their inner experiences, externalise their thoughts and become an observer of them, creating space and distance. The distance means, we can choose how to interact with it, choose whether to listen to it and choose how to act in accordance with it. We support young people to establish their values and make these choices based on their values.

To give an example, Reboot West supported a young person, Emma (not her real name), to apply for college. As the start of term drew nearer Emma became socially anxious and felt unable to attend, we asked Emma to describe the thoughts she was having, she said things like, “I’m not good enough,” “everyone will be smarter than me,” “everyone will be looking at me”. We asked Emma to write these thoughts on a piece of paper and then write, “I’m having the thought that…” above the statement, then we asked Emma to physically walk away from the thought written on the piece of paper, all the while asking her to notice the physical feelings, describing how and where she could feel the thought within her body. Over time Emma was able to recognise these thoughts were quite normal, and although uncomfortable, she was able to accept they were thoughts and might not be true, or at least not all of the time. This was a success story, Emma went on and achieved a level 2 qualification in Health and Social Care. But there are similar examples where young people didn’t continue with college that we still see as success or gain in learning value. Adam (also not his real name) decided not to continue with college, but instead of feeling defeated and ‘back at square one’ he recognised that studying might not be for him, that instead being physically active was important to him and he went on to work in construction instead. For both young people, they learned to take action driven by their values.

The above describes how Reboot West use Acceptance and Commitment Therapy (ACT), and specifically DNA-V (a youth model with ACT), to support young people to become ‘psychologically flexible’. The Reboot West team continue to learn and improve their use of ACT with monthly group clinical supervision from a supervisor with extensive experience of ACT. We have also developed a toolkit of cards for workers to enable workers to bring ACT into their sessions with young people.

Reboot West also uses ACT holistically within the project (in supervision, in peer support and even informally in their social interactions with each other), as well as externally with funders, local authority partners and with the wider support network of a young person. Partner organisations, including personal advisers and social workers in local authority leaving care teams have been trained in ACT to enable consistent language and approaches.

Through modelling ACT techniques the Reboot West team consistently assess and are driven by their own values which has led to a stable, fulfilled and successful team, with no staff turnover throughout the whole of the project, very little staff sickness relative to other similar projects within the sector, and over achieving on project outcomes targets.

Whilst there are many contributing factors to the success of the Reboot West project, it is clear that ACT has had a profound effect on the lives of the young people directly, as well the staff within the service, which in turn, again means a better service for young people.

The Reboot West team with Louse Hayes (DNA-V creator) and Duncan Gillard (educational psychologist and clinical supervisor)

To find out more about the philosophy and principles underpinning Reboot’s use of ACT, please see this article in the British Psychological Society magazine, The Psychologist https://thepsychologist.bps.org.uk/forging-brighter-futures-young-care-leavers

[1] https://contextualscience.org/act

[2] https://thrivingadolescent.com/dna-v-the-youth-model-of-act/