Charting New Paths Part 2: A Case of Successful Acceptance and Commitment Coaching Intervention in an Executive with Mild Worry Symptoms

Debby, a 59-year-old senior executive in the pharmaceutical industry, told me over the phone that she sought coaching due to her dissatisfaction with her job and life generally, mainly due to the overwhelming challenges she faced in responding flexibly to professional and private engagements. 

At our first session, Debby complained about decreased job and life satisfaction. She expressed her desire for a more fulfilling professional life and less struggle to balance her demanding job with leisure activities. Debby also wanted to live more in alignment with her personal values and life expectations. We started the session by utilizing the 'Bull's Eye' values-clarification exercise from the ACT toolkit. The first part of the exercise enables the client to reflect on her values in four key domains: work/education, relationships, personal growth, and leisure. 

According to the assessment results, Debby's personal growth and leisure domain showed the most inconsistencies in terms of living according to her values. Debby stressed that she would like to "get rid" of her problems due to intense worrying "states," which typically occurred on weekends and were usually triggered by repeated thinking about the work. We agreed that she complete a Penn State Worry Questionnaire (PSWQ) to assess the current severity of her worrying symptoms and, if necessary, refer her to the therapist. The PSWQ score showed the presence of mild worry symptoms, so there was no need for a therapist to be involved. I told her that the baseline PSWQ score would also serve as a benchmark for both of us to monitor her progression in terms of minimizing her worry levels.

At the end of our first session, we co-created the first homework assignment, which was to pick three to five values based on the Bull's Eye domains that are indispensable in increasing her job and life satisfaction to acceptable levels. Additionally, we agreed that she tries to identify situational triggers and automatic thoughts that were associated with her increased worry levels over the weekends.

At the beginning of our second session, Debby told me that she identified three priority personal values, namely, integrity, self and other compassion, and work-life balance, that she was willing to incorporate in her professional and private life to experience more satisfaction. Regarding her second homework assignment, she identified several automatic dysfunctional thoughts. According to my professional judgment, these were mainly based on low levels of unconditional self-acceptance and catastrophizing of worry symptoms. To identify other worry-inducing thought patterns, she completed Attitudes and Beliefs Scales-2 (ABS-2). Here, the most irrational thinking was noted in the demandingness, catastrophizing, and self-downing domains. We then practiced several defusing exercises, such as leaves on a stream, so that she could distance herself from dysfunctional cognitions. At the end of our second session, we discussed using the How to Cope With A Difficult Dilemma Russ Harris exercise, which we thought might be particularly beneficial to enhance her self-compassion (step 10 of the exercise) and get her more accustomed to the fact that there are no perfect life solutions (step 3 of the exercise). 

During our third session, I asked Debby whether she would be interested in doing some regular mindfulness practice to decrease her anxiety further and help her detach from her thoughts, seeing them as transient phenomena like "clouds in the sky." She very much liked a body scan exercise and expressed high motivation to do it, especially as she could practice it both in her professional and private life.

As our sessions continued, Debby's commitment to her value-driven goals began to manifest more clearly in her professional and private life. She reported significant improvements in her ability to manage her work engagements and relationships with her followers flexibly. She was also much more confident in how to achieve a work-life balance and make more time for leisure activities. The integration of mindfulness practices, especially the body scan exercises, became a cornerstone of her daily routine, providing her with the tools to remain centered and detached from work-related worries on weekends.

Due to her more flexible cognitions, Debby started approaching her professional responsibilities with a renewed sense of purpose and creativity. She became more adept at navigating complex workplace dynamics, leading with more self and other compassion and integrity, and fostering a more inclusive and supportive team environment. Her leadership transformation did not go unnoticed, with feedback from her superior and direct reports highlighting her increased approachability and the positive impact on their morale and productivity.

Conclusion

Debby's coaching journey underscores the importance of a holistic approach to executive coaching, integrating values clarification, mindfulness practices, defusion exercises, and the use of cognitive assessments to address complex professional and personal challenges. Through continued dedication to her personal development and the strategic application of the tools and techniques she learned during our coaching relationship, Debby has set a strong foundation for ongoing growth and satisfaction in both her professional and personal life. 

Implications for Coaching Practice

For coaches, Debby's story highlights the value of:

• Employing value-clarification exercises like the 'Bull's Eye' to help clients articulate and prioritize their values, setting the stage for meaningful change during the coaching intervention.
• Integrating practices such as mindfulness in the client's daily routine in cases when she complains about mild anxiety.
• Use of cognitive assessments such as the ABS-2 scale to identify dysfunctional thought patterns that are often associated with anxiety, which might prevent the client from living her life in accordance with her values and expectations

Implications for Coach Development

For coaches, Debby's journey offers valuable insights into the process of fostering change and growth in clients. It emphasizes the need for coaches to:

• Develop a deep knowledge and understanding of various coaching tools and techniques to tailor their approach to the unique needs of each client.
• Continuously refine their ability to facilitate value clarification, recognizing its centrality in driving meaningful and sustainable change.
• Increase their coaching efficiency by being more skillful and flexible in using various coaching approaches to support their clients through complex personal and professional challenges, especially when they present mild anxiety symptoms that might hinder or prolong the client's successful goal achievement.

References

DiGiuseppe, R., Leaf, R., Exner, T., & Robin, M. W. (1988). The development of a measure of irrational/rational thinking. In Proceedings of the Annual Meeting of the American Psychological Association.

Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy—new Harbinger Publications.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press.

Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behavior Research and Therapy, 28(6), 487-495.