Focus on your breath Applying contextual behavioural approaches to - - PowerPoint PPT Presentation

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Jun 10, 2023 348 likes •551 views

Focus on your breath Applying contextual behavioural approaches to working with adults with Cys9c Fibrosis Jennifer Kemp Clinical Psychologist Royal Adelaide Hospital Cys:c Fibrosis State Wide Service What is Cys:c Fibrosis? Mul:ple medical

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Focus on your breath

Applying contextual behavioural approaches to working with adults with Cys9c Fibrosis

Jennifer Kemp Clinical Psychologist Royal Adelaide Hospital Cys:c Fibrosis State Wide Service

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What is Cys:c Fibrosis?

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Mul:ple medical problems

Respiratory problems
Respiratory failure
Nutri:onal deficiencies
Secondary illnesses
Reproduc:ve problems
Transplant

CF lungs Normal lungs

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Working with the hexaflex & matrix

hKp://drkevinpolk.blogspot.com.au/p/matrix-and-hexaflex.html

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Challenges of working with people with CF

Cynical, disengaged, guarded
Treatment fa:gue, just another interven:on
Long term view, slow to trust
Some ins:tu:onalised,

passive

Resistant to mo:va:onal

interviewing

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Acceptance

Avoiding thoughts &

feelings

Avoiding physical

reminders of CF

Pretending
Changes with age and

developmental stage,

esp. adolescence

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Acceptance, avoidance & adherence

People with low levels of acceptance may be less likely to:

Engage with health

care professionals

Do daily preventa:ve

treatments

AKend clinic

appointments

Undergo IV treatment

un:l already very sick

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Other factors in adherence

Adherence

Reinforcement/ Punishment Schedules Acceptance of severity & urgency Goal a>ainment vs health Past learning & trauma Acceptance of having CF

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Crea:ve hopelessness and the gradual accommoda:on of symptoms

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Evalua:ng & building acceptance

Ask specific

ques:ons

Recognise the baKle

with thoughts and feelings

Metaphors

– Tennis – The Box

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Defusion

“I’m going to die early”
“I’m too sick”
“I’m going to get sicker

and sicker”

“I am my lung func:on”
“I’m different”

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Encouraging defusion

Thought as just

thoughts

Debunk myths
Maintain a flexible,

posi:ve expectancy

Don’t accept the sick

role

Lots of ‘future talk’

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Being in the present moment

Mindfulness, the breath & CF

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Self as context

Self as CF
Self as sick
Self as normal
Risks to each

approach

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Values

Lack of values clarity
Limited life experiences
Themes:

– Rela:onships – Helping/caring – Achievement

What about ‘health’?

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CommiKed ac:on

Focus on balance
Treatment burden
Disrup:on due to illness
Unclear :me to achieve

goals

Developmental delays
Impact of health on goals

(e.g. fer:lity)

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In summary…

Acceptance as a pathway to

adherence

Focus on balance not

treatment directly

Maintain perspec:ve that

they can have a life worth living

Build on small successes
All ACT strategies can be

used – even mindfulness of breath

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