1st Edition

ACT at the End Acceptance and Commitment Therapy with People at the End of Life

By Toni Lindsay Copyright 2024
    224 Pages
    by Routledge

    224 Pages
    by Routledge

    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.

    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


    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.

    "Toni's warmth, wisdom and years of experience shine through on every page of this book. We humans can find death difficult. The process of dying is often an aversive one in western culture, and therapists working in this space can feel overwhelmed and burnt out. Using Acceptance and Commitment Theray, Toni extends her hand and gently walks us through a way to work with clients facing the end of their life that creates an experience full of value, meaning and vitality. It is an excellent and important addition to the ACT library." 

    Julie Grove, psychologist, ACT Therapist 

    "This book is essential reading for any practitioner who would like to support people at the end of life. Through her wealth of experience, Toni is able to apply the ACT ideas to issues that arise at the end of life and also demonstrate how they are used in clinical practice to help clients live meaningfully. She has a real gift in distilling complex and abstract concepts into everyday language that every client (and therapist) will understand. This informative and down-to-earth book will leave every practitioner, no matter the stage of career, left with a plethora of practical strategies on how to support clients (and themselves) when working at the end of life." 

    Dr. Iris Bartulaclinical psychologist (psycho-oncology), ACT Practitioner 

    "Toni Lindsay's experience of working with people facing imminent death is shared eloquently in these pages. The underlying theme of acceptance is balanced with real-life examples of walking alongside someone facing death while looking for what they can teach us about thinking the unthinkable. I highly recommend the wisdom contained within this book to students and practitioners of all disciplines." 

    Professor Daniel KellyRoyal College of Nursing Chair of Nursing Research, Cardiff University 

    "With deep humanity and humility, Toni Lindsay deftly walks the reader through many facets of using ACT to work with people at the end of life. Dr. Lindsay's impressive ability to bring evidence-based strategies to life through her rich tapestry of clinical experience is a gift for both the therapist and patient and results in a guidebook that can enrich the practice of any psychologist or therapist working with people at the end of life." 

    Ursula Sansom-Daly, PhD, director of the Behavioural Sciences Unit, University of New South Wales