ACT at the End

ACT at the End is based on the principles of Acceptance and Commitment Therapy (ACT), and while it has a grounding in research, it is also a hands-on clinical guide for those working with people at a tricky and complex time of life. This treatment manual is arranged to support clinicians in stepping through common concerns and addressing the ways that people at this stage of life may require psychological support as well as strategies for supporting clinicians working in this space. The guide provides a formulated ACT approach to address each element of the Hexaflex, as well as work around self-compassion and using ACT approaches to support difficult decision making. This book provides examples that clinicians will be able to apply to their own practices and tools that they can use to troubleshoot clinical concerns. It's a helpful companion to clinicians navigating challenging terrain-much in the way that someone might turn to a colleague for advice, it is open and accessible, while still recognizing the ways in which that the work is hard.

Dr. Toni Lindsay is a senior clinical psychologist who holds a professional doctorate in clinical and health psychology and has extensive experience in working with people approaching the end of life, particularly adolescents and young adults.

Part 1: Setting the Scene. 1. Introduction 2. What Happens Around Death 3. The Psychological Bits 4. Uncertainty 5. Desire for Hastened Death 6. A Wolf in Sheep's Clothing 7. Pain and Somatic Processes 8. Complexity of Caring 9. Delicate Spaces (Religion, Sexuality, Fertility) 10. Legacy Part 2: The ACT Process 11. Formulation and Consistency 12. The Hexaflex 13. Values 14. Committed Action 15. Acceptance 16. Present Focus (Including When the Present Is Really Hard) 17. Thought Management 18. Self as Context 19. Self-Compassion 20. Supporting People in Decision Making Part 3: The Therapist Process 21. What Comes Up 22. Managing Own Stuff 23. Tolerance of Sitting 24. Saying Goodbye Part 4: Case Studies 25. Managing Physical Decline 26. Existential Distress 27. Acceptance 28. Denial 29. Not About the Dying: What's Left 30. Living a Good Death