Book Review: Inside this moment: a clinician’s guide to promoting radical change using acceptance and commitment therapy

Inside this moment: a clinician’s guide to promoting radical change using acceptance and commitment therapy, Strosahl, K. D., Robinson, P. J., & Gustavsson, T., Oakland, CA, Context Press, 2015, 232 pp., $49.95 (paperback). ISBN 9781626253247

Research suggests that the modal number of psychotherapy sessions is one (Brown & Jones, 2005). Thus, clinicians are often faced with the real possibility that their initial meeting with a client may also be their last. Inside This Moment is a book by Kirk D. Strosahl, Patricia J. Robinson, and Thomas Gustavsson aimed at providing clinicians with a trans-diagnostic model of psychotherapy and the necessary clinical tools to deliver concise, effective therapy to clients, with a strong emphasis on working in the present moment.

Inside This Moment is organized into three complementary sections. Part 1 introduces readers to the core concepts and theoretical foundation for working with clients in the present moment, and readers are invited to explore their own awareness skills. Readers are also presented with a novel, five-phase model of present-moment awareness that is expounded upon in Part 2 of the book. Specifically, each facet of the model, which consists of noticing, naming, letting go, softening, and expanding, is discussed in depth, and case examples and methods of assessing present-moment awareness help to elucidate the model. Each chapter of Part 2 concludes with practical clinical tips and gentle reminders to help clinicians avoid common clinician pitfalls. Part 3 consists of six chapters that explains how the five-phase model can be adapted and applied to common psychological conditions, including depression, anxiety, and substance use problems, among others.

Although Inside This Moment is not written exclusively for an audience familiar with Acceptance and Commitment Therapy (ACT), it assumes readers have a basic understanding of ACT principles, and clinicians familiar with the ACT model will recognize the phases of the present-moment awareness intervention as corresponding to ACT processes of change. For example, noticing and naming are related to mindfulness and self-as-context, letting go and softening parallel defusion and acceptance, and expanding incorporates values and committed action. However, what makes Inside This Moment different from other ACT-based clinician guides is the emphasis placed on using present-moment awareness exercises as the fundamental method of generating change in psychotherapy and transforming clients’ lives. In addition, the text is unique in its clear prescription of a sequential intervention paradigm, introducing the five phases in separate, successive chapters, and maintaining their sequence for the specific clinical problems covered in Part 3.

Each phase of Inside This Moment is considered essential to successfully implementing present-moment awareness interventions, and the identification of supporting neuroscientific theory and evidence grounds the text empirically. Additionally, the basic skills, clinical tips, and gentle reminders are useful for real-world application of the phases. Finally, the case examples allow clinicians to examine present-moment awareness interventions with hypothetical clients facing common psychological difficulties, and clarify the manner in which particular present-moment awareness weaknesses influence clinical presentations. Considering the trans-diagnostic and intuitive nature of Inside This Moment, and its emphasis on effective brief intervention, it is a useful text for any clinician treating a diverse clientele using a short-term model of care.

Brown, G. S., & Jones, E. R. (2005). Implementation of a feedback system in a managed care environment: What are patients teaching us? Journal of Clinical Psychology, 61, 187–198.
Strosahl, K., Robinson, P., & Gustavsson, T. (2012). Brief interventions for radical change: Principles and practice of focused acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.

Book review: Kelso, K. C. (2017). Inside this moment: a clinician’s guide to promoting radical change using acceptance and commitment therapy. Cognitive behaviour therapy, 46(2), 174.

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