Treatment modalities for ACT and IPT

IPT have distinct roles, and different patients may be referred to one of these treatment modalities yet resist treatment in some way. Rather than viewing these patients as categorically "difficult," therapists would be better off repositioning and rebranding ACT and IPT to better sell their respective models. It is also helpful to understand patient reservations, recognize there may be cross-cultural variables at stake in the communication process, or other patient-centric variables impacting their attitudes toward the particular modality.

Many patients naturally mistrust a treatment modality that is new or unfamiliar to them, or which they have never heard of before in the media. Therefore, therapists of either ACT or IPT need to use a variety of communications strategies to encourage patient compliance when necessary. It may be helpful to describe examples of noncompliant or resistant patients in order to better grasp the types of techniques used to educate and inform, with the ultimate goal of helping the patient seek the service that is right for them.

Both ACT and IPT have tremendous value as part of a therapist's treatment portfolio. Acceptance and Commitment Therapy (ACT) blends a variety of techniques like mindfulness and behavioral change techniques (Hayes, n.d.). A difficult patient may be someone who is religiously conservative or simply skeptical about mindfulness, or someone who mistrusts any technique that resembles meditation due to a misunderstanding about what these practices are and what they mean.

Focusing on a skeptic who is not religiously oriented, a therapist would be able to point the patient in the direction of the scientific underpinnings of ACT. If, however, the patient is from a religious background and has rigid worldviews, it is certainly possible that ACT is not for them.

If the patient needed to use ACT because of a formal or court-ordered recommendation, then as a therapist I would be able to "sell" the practice best by drawing a connection between the patient's religion and the tools and techniques of ACT. I might need some time compiling my "pitch," but I would eventually be able to convince a noncompliant, rigid minded patient that their religious values and beliefs are not threatened by the type of therapy they use.

In fact, ACT is multifaceted and is built on a framework of openness and exploration (Hayes, n.d.). As respectfully as possible, I would try to urge the patient to consider whether their religion is actually serving them or not. Interpersonal Psychotherapy (IPT) is a complex set of interventions and strategies that may also be recommended for patients suffering from specific mood disorders. However, some patients may be resistant or suspicious of the modality.

I would tell a difficult patient that one of the core benefits of IPT is its time limitations, in a sense suggesting that the patient has nothing to lose by trying it ("About IPT," n.d.). One specific type of patient that may be resistant to change might be someone with addiction problems who was referred to IPT through the courts.

Particularly if that person is not yet ready for change, I might reframe IPT as something that is not necessarily going to "cure" them but can be a fun way to explore what is going on with them that brought the person to this point in their lives. I would want to establish unconditional positive regard for the person, refraining from making judgments about their resistance to change.

Before giving them the hard sell on IPT, I would ask the patient about his or her interpersonal relationships to better understand their resistance to this particular treatment modality, which focuses on communication. It could be that the patient would tremendously benefit from improving his or her emotional intelligence by using techniques embedded in the IPT model, including recognizing and addressing difficult emotions, listening better to others, and realizing their differential roles. As treatment modalities, both ACT and IPT offer patients the opportunity for self-directed change.

Both of these intervention models encourage self-empowerment and change. I appreciate both, and have no resistance to either one. However, as someone who favors mindfulness as a regular practice or state, I would tend toward the use of ACT with my patients. I had also valued the input of Relational Frame Theory, which takes many of its practices from symbolic interactionism and linguistics theories.

I often recognize my own internal dialogue, and pay attention to the way language is used in my dream states as well as in my waking subconscious. Beyond the mere "self-talk" that therapists often talk about, relational frame elements of ACT provide a wealth of opportunities for exploration and growth.

Patients can explore art, music, and writing as a means to get in touch with their thoughts and feelings, expressing and then processing what is going on without reverting to the outmoded systems of judgment that have restricted the patient's ability to change or improve. I also appreciate the 'acceptance' feature of ACT, because as Dewane (2008) points.