Values in Therapy Content on Cards

Content on Cards
(Chapter 2 Tool)
This exercise uses a strategy common to many different therapy approaches: physicalizing. Physicalizing helps clients interact
with internal experiences in new and more practical ways. In this exercise, difficult thoughts, feelings, sensations, memories, and
urges that arise during values work are written down on cards that clients then interact with.

When
A Content on Cards exercise is a helpful tool to use when barriers emerge as clients seek to move toward their values. Sometimes,
this occurs early in the values exploration process. At other times, these barriers will only emerge after clients attempt to take
concrete steps toward their valued directions later in the values work process. This can also be a helpful exercise to use when
planning for anticipated barriers, for example, as part of the Values Prototyping process (http://www.newharbinger.com/43218).

Why/Function
Taking what are normally private internal experiences and putting them on cards gives the client and therapist the opportunity
to interact with these thoughts, feelings, sensations, and urges as “things.” Shifting from the perspective of looking from a
thought/feeling to a perspective of looking at a thought/feeling fosters a sense of distinction between thought and thinker or
feeling and feeler that allows for more varied and flexible responses. In this way, the exercise facilitates both defusion and flexible
perspective-taking processes.
In addition, many variations of the Contents on Cards exercise foster willingness as the client is asked to interact in a more
accepting manner with the same difficult internal experiences that they are typically trying to avoid or get rid of. Some varia-
tions highlight the unworkability of experiential avoidance by asking the client to physically reenact some of their typical avoid-
ance strategies with the cards. All of this, of course, is occurring in the present moment, one in which the client is directly
practicing attending to important stimuli in the here-and-now rather than being caught up in stories of the past or imagined
future.
Consistent with a values-guided therapy approach, the version of Contents on Cards described below ultimately functions to
facilitate valued living. It targets all aspects of psychological flexibility, namely being clear about and acting upon what matters
(values and committed action) while making room for the difficult experiences that are likely to show up along the route (will-
ingness), looking at rather than from the thoughts that might serve as barriers (defusion), and attending to what is important to
attend to in this moment (present moment), all while being able to observe the process and step outside our more limited stories
and perspective (flexible perspective taking).

How
What follows is just one variation of a Contents on Cards exercise, though the general format is often similar across variations.
Once you’ve given this version a go, try getting creative with it. You may want to look at other ACT books (e.g., Bach & Moran,
2008; Flaxman, Blackledge, & Bond, 2010; Luoma, Hayes, & Walser, 2017) for other ideas about ways to use Contents on Cards
exercises as well.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Content on Cards

Step 1: Identify a Valued Direction and Write It on a Card

Since this version of the exercise assumes you have already done some values work or the client is already coming in with a
sense of what might be important to them, you can begin by writing down that valued direction on an index card: for example,
“patiently caring for my father” or “loyally serving my community” or “being a faithful steward of our planet.” Or, for a somewhat
more evocative stimulus and to further heighten the flexible perspective-taking aspect of the exercise, you can combine this with
the Tombstone exercise (Hayes, Strosahl, & Wilson, 2012, pp. 306–307) and draw a simple tombstone on the card, filling in the
valued direction as if it were an epitaph, as depicted here:

This card then becomes the stimulus to evoke the difficult thoughts, feelings, sensations, urges, or memories that show up
when the person comes into contact with their values. Hold the card up in front of the client or even have the client hold the
card. Pause to allow any thoughts, feelings, memories, sensations, or urges to arise naturally as the client observes the card.

Step 2: Identify and Write Down Difficult Cognitive and Emotional Content
As the client observes the values card, ask them questions to elicit what mental content (thoughts, feelings, sensations,
memories, or urges) shows up for them while they are in contact with their valued direction. Questions you can ask include:

• What feelings are showing up for you right now as you look at this card?

• When you think about living this life (referring to the values card), what thoughts are coming to mind?

• What do you notice is happening in your body as you are looking at this card?

• As you are looking at this life you say you’d want to live, do you notice yourself feeling any urges?

In general, I’ve found it’s best to speak little to my client during this portion of the exercise, as I want their focus to be on
the values card. My experience has been that more uninterrupted contact with the values card stimulus tends to elicit a more
Values in Therapy Content on Cards

salient and varied response and so I tend to speak very little during this portion, only sprinkling in instructions/questions to
facilitate the process when needed.
Each time the client mentions a thought, feeling, sensation, urge, or memory that might draw them into a struggle or lead
them off track from the valued direction, write it down on a card. I call these cards the “barrier cards” because they document
the stuff that, from the client’s perspective, seems to stand in the way of them living the life they would most want to live. Keep
what is written on these cards simple, as longer descriptions may get clients stuck in the details, thereby losing contact with the
exercise. Each time you write a “barrier” on a card, drop that card in front of the client, so that eventually they are in contact
with a virtual “wall” of barrier cards. Here is an example of the stack of barrier cards that might be generated based on the case
example of Ben from chapter 2.

Step 3: Track Workability

In this step your task is to help the client physically play out some of their experiential avoidance strategies using the barrier
cards and, through that, get in contact with the workability and costs of those strategies. There are many ways to do this. Here
is a script showing one potential way this can be done.

Therapist: (holding the values card up with the barrier cards laid out between the client and the therapist) Now, you’ve said that this
is the direction you’d want your life to move toward (pointing to values card). Is this how it feels to you, that all these
things (pointing to the barrier cards) are standing between you and the life you want to live?

Client: Yes. I need to figure out how to get rid of those things (pointing toward barrier cards) so I can move toward that (point-
ing to the values card).

Therapist: But it seems to me it’s even harder than that. These thoughts, feelings, and urges (pointing to barrier cards) aren’t just
passively lying there. Rather, they seem like they come flying in out of nowhere and are really intrusive (looking at
and interacting with the cards helps facilitate defusion). So, are they more like this? (Therapist picks up barrier cards and
starts gently flicking them at the client. You may want to get permission before doing this, especially for certain clients.)
Values in Therapy Content on Cards

Client lets them fall on his lap.

Therapist: Is that normally what you do when these feelings come up? Are you happy to let them stick around or do you do what
you can to keep them away?

Client: I guess I try to keep them away. When I start thinking about this stuff, I try to go back to sleep or distract myself
with something else.

Therapist: Okay, so let’s act that out. As I toss these as you, you do your best to keep them away from you.

Client hands back all the cards to the therapist and then the therapist rapidly tosses the cards at the client as he frantically
tries to bat them away.

Therapist: So right now, as you try to defend yourself from these thoughts and feelings, what are you focused on (facilitating
present-moment awareness)?

Client: The cards coming at me.

Therapist: Yeah, it looks like as you’re trying your best to get away from these things (pointing to the barrier cards), you’re not
really able to fully focus on what you say you’d want to focus on in your life (pointing to the values card).

This stage can be as long or short as needed in order to help the client experientially understand the workability or unwork-
ability of their attempts to get away from or protect against their painful thoughts and feelings. You can also ask the client how
it feels to spend their time trying to get away from the barrier cards, or how easy it would be to move toward the values card while
still trying to get away from the barrier cards coming at them. In addition to tossing cards at the client and them trying to deflect
them, other variations of modeling experiential avoidance or fusion are possible. For example, if the client is particularly attached
to the stories on the cards, wanting to defend them or figure out an answer to them, the therapist can have the client hold tightly
to the cards while the therapist pulls on them, as if in a tug-of-war. Alternatively, if the client identifies with the idea of pushing
the thoughts or feelings away, then the therapist might move the cards slowly toward the client while the client uses their hands
to push back on them to see the consequences of constantly exerting effort to push these difficult experiences away. If the client
feels like fleeing from the cards, the therapist and client could stand up and act out what happens as the client tries to physically
flee the cards, as the therapist “chases” them with the cards.

Step 4: Connect Values and Pain and Offer Willingness as an Alternative

The script now continues on to offer a willingness alternative to experiential avoidance.

Therapist: Tell me if this fits with your experience: it seems like as soon as you start focusing on the things that are important
to you, all these things (pointing to barrier cards) show up and eventually you get pulled off course as you struggle with
them.

Client: Yes, that’s exactly the problem.

Therapist: I can see the problem there (takes values card and the barrier cards and puts them in one stack). From what you’re telling
me, it seems like when you focus on your values (shows the values card side of the stack), then these things also show
up (shows the side with the barrier cards).

Client: Right, and I can’t seem to figure out a way to separate them.

Therapist: What if we tried something other than separating them? Would you be willing to let me put these in your hand
(referring to the stack of cards that contains both the barrier cards and the values card)?
Values in Therapy Content on Cards

Client: Okay. (Therapist places stack of cards in the client’s hand with the value card on top.)

Therapist: What is your attention on now?

Client: The top card. The one with my value on it.

Therapist: And if, let’s say that moving toward this door behind me was moving your life in the direction of that value, could
you do that while still holding all these cards, including the barrier cards?

Client: Sure.

Therapist: I wonder if it works more like that? It seems like we need to separate your barriers from your values and get rid of the
barriers, but maybe how it actually works is that focusing on trying to separate them is part of the problem. What if,
instead of trying to separate them, we need to learn how to help you bring them with you as you still move toward
the direction you want? I’m not saying I know this will work for you in your life. I don’t know. We haven’t run that
experiment. (Therapist is trying to encourage tracking workability via direct experience rather simply fusion with alterna-
tive thoughts.) I’m just saying that it seems like one possible hypothesis we might want to test out given that you’ve
spent a lot of time testing out the separation strategy and we kind of have a sense of how that works.

Step 5: Effective Action Practice

Therapist: Would you be interested in doing some hypothesis testing for homework this week about this?

Client: Sure.

Therapist: Okay, how about if you take these cards, all of them, and commit to carrying them around each day, maybe in your
pocket or your purse. Then once a day, you can take them out and read them, noticing what it is like to carry around
these thoughts, feelings, urges, and memories in this way, rather than fighting them or trying to avoid them. And
also read the values card so that you can be reminded of why you are carrying around the tough cards (tracking
valuing as it is occurring while doing the homework), what they are connected to. How does that sound?

Client: Good. I could do that.

Therapist: Great. And remember, since we’re collecting data here about our hypothesis, it can be helpful to take some notes of
anything you observe as you run the experiment this week.

Client: Okay, I’ll do that.

Troubleshooting the Content on Cards Exercise

The most common difficulty I see when therapists first start working with the Content on Cards exercise is that they fail to
catch fusion in action. The exercise usually starts off well, with the client talking about thoughts or feelings that come up when
they make contact with their values. During this, clients generally talk about thoughts and feelings that show up in some other
context, in the there/then. These are typically easy to notice, and the therapist writes those thoughts, feelings, and sensations
down on the cards. This is a good start, but I find the real learning occurs with what happens next.
In order to have this be an effective experiential learning exercise, we need to have the client actually interacting with the
barriers and values in the moment, those in the here/now. These are sometimes harder to catch, but it’s important that you do.
For example, the client might tell you that when they start thinking about engaging in valued action, thoughts of being worthless
Values in Therapy Content on Cards

and feelings of sadness often show up. You write those down. Then the client might say something like this, directly to you, seem-
ingly breaking out of the exercise:

Client: I don’t know why I’m bothering to do this. This is stupid. I just need to suck it up and start doing the things I should
be doing in my life.

At this point, it is very common for therapists to leave the exercise and engage in a dialogue with the client in response to
their statements. But doing so misses an opportunity to defuse from this thinking. Instead, try sticking with the exercise by
saying something like this:

Therapist: Great, so those are also thoughts that show up as soon as you start doing something that is in the service of your
values, like you’re doing right now. Let’s put those down too. Do you have any feelings that are showing up right now?

Client: I guess I feel frustrated and hopeless.

Therapist: Okay, great. We already have hopeless down on a card, but let’s add a frustrated one. (Therapist adds cards like the
ones below.)

Those cards then get treated just like any of the other barrier cards. This is an example of catching fusion and experiential
avoidance as they are occurring in the moment and practicing acceptance and mindfulness strategies in response to them. This
principle operates throughout the exercise and is an example of how this exercise is meant to be a form of experiential learning.
As new difficult thoughts or feelings arise during the exercise, they can be written down on additional cards and added to the
pile.

References
Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance and commitment therapy. Oakland, CA: New
Harbinger Publications.
Flaxman, P. E., Blackledge, J. T., & Bond, F. W. (2010). Acceptance and commitment therapy: Distinctive features. London, UK: Routledge.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd
ed.). New York: Guilford Press.
Luoma, J. B., Hayes, S. C., & Walser, R. D. (2017). Learning ACT: An acceptance & commitment therapy skills-training manual for therapists
(2nd ed.). Oakland, CA: New Harbinger Publications.
Values in Therapy Charlotte: Helping Clients Notice Their Preferences

Charlotte: Helping Clients Notice Their Preferences

(Chapter 3 Clinical Vignette)
Some clients have a history of abuse, neglect, or chronic invalidation wherein they were never encouraged to or supported in
learning about their own preferences, wants, desires, or needs. They get what they prefer confused with what others prefer, what
they have been told they prefer (but actually don’t), or internalized rules about what they should prefer. They forget to take into
account their current state—for example, whether they are hungry, angry, sad, anxious, or tired. They may mislabel what they
feel based on what others have told them or may not even know what they feel in a given moment. They may totally ignore
themselves, their preferences, and their experience, responding instead based on rules or “shoulds,” and thereby lack compassion
for themselves. Many of these clients will likely need some practice with the basic process of choosing, including learning to
notice their own preferences, before you launch into more extensive values exploration. What follows is a clinical vignette that
demonstrates how you might help your clients learn more about their preferences and the process of choosing.

Clinical Example
Charlotte was a twenty-one-year-old woman who was entering therapy voluntarily for the first time, having previously been
through several court-mandated evaluations and a handful of mandated therapy sessions growing up. Although extremely polite,
Charlotte seemed very cautious and unsure about being in therapy, which, given her history, is exactly how it should have been!
Charlotte grew up with parents who had substance use problems. Her mother was largely absent from the home, appearing
only occasionally before she died of an overdose when Charlotte was eight. Charlotte’s father was her primary caretaker. At age
twelve, Charlotte was removed from the home and put into foster care due to physical and sexual abuse by her father. The gov-
ernment eventually terminated her father’s parental rights and Charlotte bounced around several different foster homes until she
was eventually adopted at the age of sixteen.
Despite, or maybe because of, this difficult early history, Charlotte was an incredibly resourceful, resilient, and tenacious
young woman. When I first started seeing her, she had just started classes at the local community college. She came into therapy
with only one treatment goal: not to “end up” like her parents. She knew what she didn’t want, but did not have a sense of what
she would want from her life. When I offered potential suggestions of more specific or “toward-focused” treatment goals, such as
“Would you like to work on having more meaningful or safe relationships?” or “Would you like to work on being healthy and
being respectful of your body?”—she was engaging in some pretty risky sexual behavior, self-harm, and periodic substance
abuse—she gave noncommittal responses like, “Sure, that sounds fine” or “If that’s what you think would be best.”
Charlotte’s pliance-based responses, as well as what I had learned about her early history, suggested that I might need to take
a step back in our values work to start with the basics on helping her practice choosing. This young woman had a lot of practice
figuring out what others (such as her parents, her foster care families, her case managers, and her therapists) wanted from her,
but very little learning history that would have helped her know what she wanted. She’d never even had the chance to make basic
choices based on her preferences, like whether she preferred chocolate or vanilla ice cream, let alone what she would choose for
a meaningful and well-lived life. So, that’s where our work started—with basic choices.
Here is an example of what some of that work looked like. This dialogue comes from maybe our fourth or fifth session
together. It picks up immediately after I had intentionally tried to display my approval for something Charlotte had said regarding
a book she was reading.

Therapist: Charlotte, which do you prefer, chocolate or vanilla ice cream?

Charlotte: I don’t know. I guess whichever is around.

Therapist: But do you know which one you would prefer if both were available to you and you were totally free to choose?

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Charlotte: Helping Clients Notice Their Preferences

Charlotte: Not really. Those sorts of things are confusing to me. I just end up randomly picking something usually.

Let’s pause here. I really don’t care that much about Charlotte’s ice cream preferences. But we weren’t really talking about ice
cream. We were talking about how she goes about the process of choosing or even just knowing what she likes. For example, the
way she described choosing between chocolate and vanilla ice cream is the same strategy she used for choosing what sexual
behavior she would engage in. In her sexual encounters, she would usually decide what to do primarily based on what she deter-
mined the other person wanted. Then, if she couldn’t figure that out, she would end up just randomly deciding based on what
she thought were her limited available options. Unfortunately, she never really saw having a mutually satisfying and caring sexual
relationship as being among the options available to her. So, as I said, we weren’t really talking about ice cream here. It’s just that
ice cream is an easier and safer thing to experiment with than, say, sexual relationships—so that’s where we started. The dia-
logue continues below.

Therapist: I’m curious, how do you think I was feeling a minute ago when you were telling me about the book you were reading?

Charlotte: You seemed to be amused by it. And you seemed interested.

Therapist: Yes, that’s right on. I thought the book sounded funny and I was interested in it. (Here I wanted to give her direct
feedback about the accuracy or inaccuracy of her observations about others’ feelings and preferences.) What would you
guess I might like to do in my free time?

Charlotte: Well, I figure that you probably like to read a lot. I also think that you don’t really watch much TV or like movies or
things like that.

Therapist: Yes, you got all of that right (again, reinforcing her accuracy in noticing preferences). But I’ve never told you any of that
before, so how do you think you figured that out?

Charlotte: I don’t know. I guess I just kind of notice those things. Like when I talk about books in here you seem interested and
you have more to say about it. And you never mention TV or movies and sometimes, no offense, but you don’t seem
to really get it when I make pop culture references. So, I figured that you don’t really like that stuff.

Therapist: Great! So one of the ways you have gotten really good at figuring out what other people prefer is that you pay atten-
tion to the small things, like what they talk about, subtle displays of interest or pleasure or displeasure, that sort of
thing, right?

Charlotte: I guess so. I hadn’t ever really thought of it like that. I just kind of do it.

Therapist: Yes, and you’re really good at it. You had a history that made it really important for you to get good at figuring out
what other people wanted. But it seems to me like you don’t have much practice in turning those same skills on
yourself, in being able to read your own subtle cues to know what you might want or prefer.

Charlotte: That’s probably true.

Therapist: So, you had a history in which it was more important for you to focus on what others wanted than what you prefer.
And getting really good at that helped you survive when you were a kid, which I’m so glad you did. But now it’s kind
of confusing to not know what you prefer. How about if we start practicing some of that? Would you be willing to
come over here and sit in my chair?

(Charlotte moves over to sit in my chair across from where she was sitting, and I kneel next to her. At this point, I shift my
use of pronouns to start talking about Charlotte in the third person, like she and I are looking over at the empty chair at this
other person called Charlotte. Because Charlotte is good at noticing things in others, I wanted to harness some of those
perspective-taking skills to help her start noticing her own preferences.)
Values in Therapy Charlotte: Helping Clients Notice Their Preferences

Therapist: Imagine you and I are looking out here (pointing at the empty chair where Charlotte had been sitting) at Charlotte lis-
tening to this conversation about choosing and preferences. What do you see on her face as I ask her about her
preferences?

Charlotte: I’d say she looks confused but interested.

Therapist: And if you saw someone display those looks, would you guess that the person might be interested in this idea of
learning to choose and notice preferences or do you think they might not choose to pursue that?

Charlotte: I guess since the person looks interested, they would probably choose it, but they are also confused, so I’m not sure.

Therapist: Cool! Sounds like the person sitting over there, the Charlotte over there, is displaying signs that she might be inter-
ested in exploring her preferences, but maybe is also a little unsure of what that means or how to go about doing it.
So she might need some extra guidance?

Charlotte: Yes, that’s right.

Therapist: Great! So how about we do something to help her start practicing.

(At this point I had Charlotte move back to her original chair and shifted pronouns again to return Charlotte to the perspec-
tive of “I.”)

Therapist: As a first step, how about for homework this week, you buy yourself some vanilla ice cream and some chocolate ice
cream. Then take a bite of each of them in front of a mirror and just be curious about what you can tell based on the
subtle responses you see in the mirror. (I asked Charlotte to look at herself in a mirror while eating the ice cream because
she had difficulty noticing internal bodily sensations or feelings, but was very good at reading other people’s facial expres-
sions. Seeing herself in a mirror becomes a perspective-taking strategy whereby she can apply her skills at reading people’s
facial expressions on herself. However, if you have a client with significant food or body shame, you probably wouldn’t want
to have them do this exercise in front of a mirror, as shame might impede their ability to do the exercise.) You can just
pretend you’re trying to read someone else and you’re trying to figure out what they might like. Would you be willing
to do that?

This is an example of something you might do with a client in order to practice choosing and noticing preferences. Charlotte
and I did lots of these simple preference-noticing exercises together and eventually she got much more skilled at being able to
track what she preferred and what she would choose. She ended up preferring vanilla, by the way.
Values in Therapy Values Card Sort Cards

Values Card Sort Cards

(Chapter 3 Tool)
The attached cards are formatted to be printed on Avery 8371, so that they can easily be punched out and made into cards.
Alternatively, you can print on card stock and cut by hand.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
 Boldness Autonomy
To be willing to undertake things To promote self-determination
that involve risk or danger and independence

Hard Work Challenge

To work hard and well at my To take on difficult tasks
life tasks and problems

Discipline Virtue
To be disciplined and exercise To live a morally pure
self-control in my own actions and excellent life

Honesty Dependability
To be honest and truthful To be reliable and trustworthy

Adventure Creativity
To seek out new and To generate new and original
exciting experiences ideas, concepts, or products
 Openness Growth
To be open to new experiences,
To keep changing and growing
ideas, and options

Beauty Ecology
To create and/or appreciate To live in harmony with
beauty around me the environment

Health Humor
To see the humorous side
To care well for my body
of the world and/or
and physical well-being
bring humor to others

Knowledge Curiosity
To learn and contribute To be curious and discover
valuable knowledge new things

Passion Rationality
To have deep feelings about
To be guided by reason and logic
ideas, activities, and people
 Spirituality
Simplicity To seek connection with the
To live life simply supernatural or something
beyond the material world

Tradition Commitment
To follow respected patterns To make enduring,
of the past meaningful commitments

Responsibility
To make and carry out Fun
responsible decisions and To play and have fun
meet my obligations

Leisure Nonconformity
To question and challenge
To take time to relax and enjoy
authority and norms

Genuineness Connection
To act in a manner that is To create close, supportive
true to who I am relationships with others
 Intimacy
Romance To share my innermost
To have intense, experiences with others;
exciting love in my life to fully know and be known
by others close to me

Respect Generosity
To extend respect and To give what I have to others
consideration to others

Compassion Peace
To feel and act on concern To work to promote peace
for the suffering of others in the world

Justice Helpfulness
To promote fair and equal To be helpful and
treatment for all useful to others

Contribution Problem Solving

To offer meaningful, lasting, and To figure things out and
positive influences on the world find solutions to problems
 Piety Gentleness
To act consistently with my To be kind, tender, or
religious faith and beliefs mild-mannered

Community Creation
To be a part of and To build, design, and/or
contribute to a group repair things

Security Loyalty
To maintain the safety
To be loyal to friends,
and security of myself and
family, and/or my group
my loved ones

Loving Competency
To have relationships involving To be skilled at and
tenderness, love, and affection effective in what I do

Authority Courage
To have authority and
To act with courage and bravery
be in charge of others
 Friendship Courtesy
To build close, To be considerate and
supportive friendships polite to others

Thoughtful Inclusivity
To be aware of and
To be welcoming and
considerate of the needs
including of all
and wishes of others

                                     

This value is very

                   important to me

This value is important to me This value is less important to me

Values in Therapy Four Qualities of Effective Values Conversations

Four Qualities of Effective Values Conversations

(Chapter 4 Tool)
When looking for effective values conversations, what is said usually isn’t as important as how things are said. Four qualities that
can serve to guide your values conversations include vitality, choice, present-moment focus, and willing vulnerability. As you
observe the accompanying video, see if you can identify moments that embody some of the below qualities of effective values
conversations. Once you are done, you can check your answers to some of my comments that follow this form and watch it again
if you wish.

Background to read before you watch the video: Before you begin working with this video, please note it is not meant to be an
example of a “perfect” values conversation. There are lots of things that I do in this video that I wish, looking back on it, I would
have done differently. However, I’m not sure about you, but I don’t always have the perfect values conversation (meaning, I never
do). Instead, I wanted to show you a more typical values conversation that still demonstrates some of the core qualities we’re
looking for in values conversations. It is a values-based action for me to have this out there in the world, and I hope it is of service.
The person you see me working with (we’ll refer to her as Z) volunteered to record a video that she knew was going to be
part of this book. We had never met before she came in to record the video and I didn’t have any sense of what she would be
talking about. While she is not an actual therapy client, she is also not role playing. She generously and courageously agreed to
talk about a values issue she is personally struggling with in order to help book readers learn more about doing effective values
work. I want to extend my deepest appreciation and admiration for her willingness to step forward in this way in the
service of her values.
The video you will watch picks up about twenty minutes into the “session.” In the first twenty minutes of the video, Z talks
about her current job and living situation and how she wants to be in her role as a mother. She talks about feeling torn between
the demands of her job and of living in an expensive city and how she wants to raise her children. During this part of the
meeting, she casually mentions how she used to play cards with her two brothers as a child. There was a sense of vitality and
choice as she talked about those times that told me I was getting close to a “truffle” (see chapter 4 of Values in Therapy for the
truffle dog metaphor). I decided to use that memory as an entry into values by having her engage in an abbreviated version of
the Sweet Spot exercise (see chapter 4). The video starts near the beginning of this Sweet Spot exercise, after we have already
spent a few minutes helping her get centered. As I’m leading her through the exercise, I’m attending to Z’s nonverbals—mostly
her facial expressions during the exercise, to give me information about when I’m getting close to some values. The Sweet Spot
exercise ends around 5:24, if you want to skip ahead to the conversation after.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Four Qualities of Effective Values Conversations

Vitality: Effective values conversations that have a quality of being “alive.” They are conversations that have energy or vitality
to them. There may be a freshness or sense of ongoing discovery. This sense of vitality doesn’t always mean they are pleasant or
filled with joy or hope. Sometimes the energy is one of deep longing, sorrow, or loss. But regardless of the valence of the emotion,
there is some life to it.

Client behavior that reflects this quality What did the therapist do to occasion the response?

Choice: By choice, we are speaking of the experience of values being freely selected, without avoidance, coercion, rigid rules, or
social manipulation. ACT works to break up a sense of “have tos,” “musts” and “shoulds” to create a sense of open possibility.
Clients can feel coerced by their own history, their own feelings and thoughts, by others, and even by their own values. Keep your
therapeutic antennae out for this sense of coercion, and its alternative, choice, in the room. An expansive quality can also be a
hint that choice is present.

Client behavior that reflects this quality What did the therapist do to occasion the response?

Present-oriented: While conversations about values extend into the future, to value something means you are valuing it now,
not in some other time or place or context. In this way, values conversations are always present focused. We are interested in
what the person is valuing and would choose to value in this moment not at some other point, under other conditions. Values
work brings the extended future into the present moment in the service of building larger and larger patterns of action linked to
valued life directions. Values work pulls extended appetitive consequences forward in time.

Client behavior that reflects this quality What did the therapist do to occasion the response?
Values in Therapy Four Qualities of Effective Values Conversations

Willing vulnerability: Caring deeply opens us up and exposes our most tender parts. If someone is in contact with something
they care deeply about, they are exposing their vulnerability, and that vulnerability will be present in the conversation. There is
often a tenderness or bittersweetness when contacting values as we can only be hurt in areas we care about. But there is also
incredible power, courage, and a fierceness that shows up when someone is willing to be vulnerable, to risk, in the service of what
is most important to them.

Client behavior that reflects this quality What did the therapist do to occasion the response?

Commentary
I recommend you read the commentary below only after you have watched the video and recorded your own answers
using the form above. Then watch the video again to compare your answers to my commentary below. There may have been
other moments in the video where these qualities showed up that I missed that you might see, but hopefully these will give you
a few examples of what I’m tracking as I am having this values conversation.
What follows are some of what I was seeing in terms of the four values qualities that helped guide my intervention.

Video start: Throughout the Sweet Spot exercise the client is tearful, suggesting she is emotionally engaged with the exercise.
Even though her eyes closed, she seems to move into the visualization without a sense of resistance or pulling out of the
exercise.

5:57: Willing vulnerability. When the client says, “I’m just, like, missing my brothers,” I note that that there is a tenderness and
vulnerability in her longing for her brothers and for the values that were present in that scene that is reflected in the tone of her
voice, her pause, and her tears.

7:20: Present moment. The client says, “All we have is the game and each other at that moment. At least when I look it at it’s
like, Oh yeah, we’re just so focused on playing the game and being together and having fun with each other…” Here I’m noticing that
even though she is describing a scene that occurred in the past, she is using the present tense frequently in her speech, indicating
she is still contacting the values in the present.

9:48: Vitality and present moment. Z is looking up, as if she is dreaming or wishing, and there is a catch in her voice. She then
says, “I guess there is just this longing.” She is tearful. When I see clients in the act of longing, as I did here with Z, it indicates
something about what they would choose. There is life in that longing as demonstrated in Z’s voice and in her nonverbals. She
isn’t talking about some conceptual ideal in the future; she is actually contacting in this this moment something that is precious
to her.

10:04: Choice and willing vulnerability. When the client says, “That’s part of what I want,” her tears and her voice suggest the
vulnerability has returned. Her sense of longing suggests that this is something appetitive for her, something she would freely
choose if given the opportunity.
Values in Therapy Four Qualities of Effective Values Conversations

11:20: Vitality. When she says, “I’ll just see when I look at her, when we’re really connected,” her eyes get bigger, she is more
animated, and she is spontaneously smiling more.

11:54: Choice. When she says, “I want a life with her where I’m there,” I notice a sense of free choice in what she is saying. At
the beginning of the session, prior to the exercise, she was using a lot of “should” and “I know I need to…” statements when
talking about how she wanted to be as a mother. Here there is none of that. She is simply and definitively saying what she would
choose to have in her life with her daughter. I want to highlight this sense of choice in order to help her discriminate between
that and when she was operating from a place of “shoulds” or guilt.

16:03: Vitality and willing vulnerability. When she says, “We had each other,” I noticed she seemed to pause, she looked down,
and became somewhat more demonstrative. She appears to be sharing something tender and vulnerable. Those qualities sug-
gested there was something important in that phrase and I wanted to follow up with that, which I do at 16:35, at which point she
becomes tearful.

16:57: Willing vulnerability. When she says, “I miss them,” there is clearly something tender and bittersweet about this moment
of missing and longing. This again suggests to me that there is something here that is meaningful to her and that she might
choose to bring into her relationship with her children.

18:10: “Without it being…” Notice here she pulls out of the experience and goes into her head. She begins to speak more quickly,
literally pulls her body back, and seems to retreat into stories about what she should/shouldn’t do. She’s still talking about “values”
here but it’s in a more intellectualized way. I want to move her away from this and back into her actual contact with the values
via defusion and the present moment by saying “So right there, what happened when your mind came in and did…”

20:26: Present moment and willing vulnerability. When she says, “Ya, and I’m just looking at her with love and apprecia-
tion…” she is speaking in the present tense, as if she is currently in that moment looking at her daughter. There is a tenderness
and vulnerability in her voice and in expressing appreciation. It’s almost as if her daughter were here now and the consequences
she is wishing to contact are happening in the room. This is a good example of the present-moment quality. We have brought
the desired reinforcers into the room so that they can be contacted now.

22:48: Vitality, choice, and present moment. When she says, “This is what matters and I just want to focus on what matters,”
she is more in the present, making a choice to value now. Contrast this with a statement that a client might say like, “That would
be something that would be important to me,” which is less about choosing now and rather implies there is some barrier that
must be overcome to choose the valued direction. There is also life in that statement. The tone and quality of her voice and the
nonverbal gestures add to the sense of vitality and suggest that she is in a place of free choice rather than trying to figure out
what she “should” do or being constricted by guilt or regret.
Values in Therapy Frank: Using a Photo with the Pain/Values Coin Metaphor

Frank: Using a Photo with the Pain/Values Coin Metaphor

(Chapter 5 Tool and Clinical Vignette)
Pain and values are like two sides of the same coin; they go together, and you cannot have one without the other. One way to
make this commonly used coin metaphor more personally apt and evocative is to incorporate the use of a personal photo or
image.

Instructions
Ask the client to bring in a photo of something or someone they care about but around which they also have some pain or
struggle. If you are working with someone who reports to have lost touch with anything they care about, ask them to bring in a
photo or an image of something they used to care about at one point but now feel they are disconnected from that caring. The
photo can be a picture of their children, their partner or other loved one, themself as a child, or a scene that represents some
valued domain such as nature or spirituality. After you have introduced the concept of values and pain being like two sides of
the same coin (see http://www.newharbinger.com/43218), the client is led to interact with the photo (for example, looking at,
reflecting on, or talking out loud to me about it) while also being coached to notice painful thoughts, feelings, sensations, or
memories that emerge. The painful thoughts, feelings, or other private experiences are either written on the back of the photo
or on post-it notes that are then affixed to the photo. What follows is a clinical example of how to incorporate a photo into the
two sides of the same coin metaphor.

Clinical Example: Frank

Frank’s husband, Jack, had given him an ultimatum: “Go to therapy or I’m leaving!” Jack had been complaining for years that
Frank was “emotionally distant” and that he didn’t seem to care about anything except work anymore, including the couple’s two
children. Frank acknowledged that he had been feeling increasingly emotionally flat and detached over the years since they got
married and especially after they had kids.
Frank hadn’t always felt this way, though. He described being “swept off his feet” and “head over heels” in love in the begin-
ning of his relationship with Jack. He could also recall the almost overwhelming joy he felt when the couple first adopted their
two children. But now he would say he just “felt nothing” and was quite emotionally flat when he was with Jack and the kids. He
expressed feeling significant shame and distress over what his lack of feelings meant about what “kind of person” he was. This
was very painful and so, understandably, Frank started trying to escape the pain he felt around his emotional flatness by spend-
ing more and more time away from his family, staying at work until late in the evening and going away on work trips many
weekends, which only served to increase the distance from his family.
Frank knew there was something very important to him in his relationships with his kids and Jack, and yet he had lost touch
with what that was. Frank’s struggles in his relationship with his kids seemed most important to him. He was resolute in his
commitment to being a “good” father to his kids, even if he had lost contact with what exactly “good” meant to him. For those
reasons, I decided to start with exploring the pain he was struggling with in relation to his kids as an avenue to helping him
reconnect to what he might choose to be about in that relationship. I had asked Frank to bring in a photo of his children. What
follows comes from the session when Frank brought in the photo.

Therapist: (holds up the photo Frank had brought in of his children) When you see this picture, these two kids looking back at you,
what do you see?

Client: I see two really great kids who had a rough start in life and who deserve better than what I’m giving them as a dad.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Frank: Using a Photo with the Pain/Values Coin Metaphor

Therapist: So, one thing that happens when you look at this picture is that the thought “they deserve better” shows up.
(Therapist writes “They deserve better than me” on a post-it note.) What other thoughts show up as you’re looking at
this picture?

Client: I feel like I suck at being a dad and I worry that I’m going to screw up my kids like my dad screwed me up. I just want
to be a good dad, that’s all.

(Therapist writes on post-it notes: “I suck at being a dad,” “I’m going to screw up my kids,” “My dad screwed me up,” and
“I want to be a good dad.”)

Therapist: So, these thoughts also come up as you’re looking at the kids. (Slowly shows each post-it note to the client.) What feel-
ings or sensations are you noticing in your body right now? (Because Frank was very attached to the idea that he didn’t
have any “feelings,” it was important to also ask him to notice sensations to sidestep the “I don’t feel anything” response I felt
I was likely to get if I just asked about feelings.)

Client: I have a pit in my stomach. Everything feels heavy, especially in my chest and shoulders.

Therapist: (writes “pit in stomach” and “heaviness in chest and shoulders” on post-in notes) From here it also looks like maybe your
eyes are starting to tear up. Do you notice that?

Client: I hadn’t really, but yeah, I guess that’s happening too.

Therapist: (writes “tearing up” on post-it note) Keep looking at this picture of these two young kids. (Continues holding the picture
up to client.)

Client: (begins crying) I just don’t know what is wrong with me! Why can’t I just love them like they deserve? I mean I know
I love them, but I just don’t feel it. I feel dead inside.

Therapist: (writes “What’s wrong with me,” “Why can’t I love them,” “I love them,” “I feel dead inside” on post-it notes) That is a
whole lot of really painful stuff that comes up for you, and especially painful I imagine because it shows up when you
connect with the two people you care about the most in this world. Given that all of this painful stuff shows up when
you’re in contact with your kids, it makes sense that you might have the urge to stay at work rather than be at home.

Client: But that’s what my dad did. I’m just like my dad and I hate that.

Therapist: (writes “I’m just like my dad” on post-it note) Okay, so let’s keep looking at this picture. Really look at these two sweet
kids, kids who had a pretty rough start to this world. (Pausing to let client take it in. Client continues to cry.) If you could
wish anything for them, what would it be?

Client: I just want them to know that they are loved. I want them to get to have everything normal kids have that they never
got. I want them to be able to play and have joy in their lives. I want them to feel safe and know that no matter what,
Jack and I love them and are here for them. And I want them to be kind and for others to be kind to them.

Therapist: I heard several things there. I heard words like love, play, joy, safe, kind (writes each of those words on post-it notes)
and something about them knowing you’ll always be there for them, maybe something like committed?

Client: Yes, I am really committed to them.

Therapist: (writes “committed” on post-it note) It’s really clear what kind of father you don’t want to be, one like your father was
to you. You know you would choose to be a “good” dad if you got to choose. If you thought about being a dad who
could bring love, playfulness, joy, safety, kindness, and commitment to your relationship with your kids, if they could
know you to be that kind of dad, would that be at least part of what you think being a “good” dad means?
Values in Therapy Frank: Using a Photo with the Pain/Values Coin Metaphor

Client: Absolutely, but I’m not that kind of dad. I’m a terrible father. I’m always working and never make time for them.

Therapist: (writes “I’m a terrible father,” “I’m always working,” “I never make time for them”) So there it happened again. Did you
notice that?

Client: Notice what?

Therapist: As soon as we started talking about some of the things that would matter most to you in your relationship with your
kids, like being playful with them, being a source of joy, safety, and commitment in their lives, your mind immedi-
ately gives you a bunch of painful thoughts, like “I’m a terrible father.” That’s the same thing that happened at the
beginning when I asked you to just connect with your kids by looking at the picture of them. As soon as you connect
with something that matters to you, lots of painful stuff also shows up. So it seems like it’s kind of like this (puts all
the values on the front side of the picture with the kids on it and all the painful thoughts and sensations on the back of the
picture). These seem to go together. You don’t get to have this (pointing to picture of kids and the values) without also
having these things (pointing to the side with the painful thoughts) showing up at times. Maybe pain and the things that
are most important to us are like two sides of the same coin. You don’t get to have one without the other.

Client: Okay, but then what do I do about it?

Therapist: That’s totally up to you. It seems like there’s a choice, though. So far, it seems like you haven’t felt much choice. It’s
totally understandable that if you think having these thoughts and feelings actually means you’re a terrible father
(pointing to the painful post-it notes), then you’d do whatever you can to avoid having them, including staying away
from the things that bring up those painful thoughts and sensations, like being at home with your kids. You’ve paid
a high price because, in doing so, it seems like you’ve also given up this stuff (points to the picture of the kids with the
values post-its on them). But if it’s the case, as it seems to be, that having these painful thoughts and feelings is an
inevitable part of being connected to who and what matters most to you, then you could choose whether or not it’s
worth it. If it’s a package deal, would you choose to have a life that was in the service of this (pointing to the values
side) even if it means that that life comes with all of these (pointing to the painful side)?

For homework that week, I asked Frank to keep those post-it notes on the front and back of the picture of his kids and take
it out once a day, looking at both sides and reflecting on what he would choose if his values and pain were that package deal.
Would he choose to lose the values in order to avoid the pain? Or would he choose to be there for his kids in the way he would
most want even though that also inevitably would mean more pain for him?
Values in Therapy Standard Eulogy Exercise

Standard Eulogy Exercise

(Chapter 5 Tool)
This is a script for using the Standard Eulogy exercise (Hayes, Strosahl, & Wilson, 2012) in session with a client. This version
mainly focuses on what the client would want others to say about the life they have lived, assuming they had lived their ideal
valued life. You can also use the context of an 80th birthday party or a retirement party at the end of a career instead of a funeral.
Regardless of the scenario you choose, the point is to have your client imagine that they have lived their ideal, meaning-filled
life and what others might say when reflecting on that well-lived life. Below is a script to use with your clients when doing this
exercise.

Instructions
Therapist: If you’re willing, I’d like us to do an eyes-closed exercise that might help us explore this issue of values a bit more.
People have all sorts of different experiences with this exercise and I’m not looking for one particular “right” answer.
Some people find that something interesting or surprising comes up in the exercise, and others feel like it simply
helps them get in touch with something that they’ve known all along. So, let’s just see what happens for you.

If you’re willing, you can gently close your eyes, or if you prefer, you can just rest your gaze at a spot on the ground.

(Lead them through a few brief centering tasks, such as noticing five senses, noticing their breath, and so on.)

Now what I’d like you to imagine is that you have reached the end of your life. It’s been a long and very meaningful
life. It’s been a life well lived. Although you’re sad to reach the end of the journey, as you look back on the life you
have lived, you feel a sense of pride and appreciation that your life has meant something important. Just take a
moment to imagine feeling good about the life you have lived once you have reached the end of it. Notice what that
feels like. (Pause.)

And through some twist of fate you have died, but you are able to attend your own funeral in spirit. You are watching
and listening to the eulogies offered by the people who are there to remember you. Your friends, your children, your
partner, your colleagues (list specific people who might be there for the client) are all there. See if you can just picture in
your mind’s eye what it’s like being there in that situation and see if you can get yourself into that room emotionally.
Notice what smells might be in that room, all the different sounds, notice what the lighting looks like. (Pause.)

Now, as they do during funerals, some people stand up to give a eulogy. I want you to imagine who you would want
the first person to be to stand up to speak for what your life, this really well-lived life, has been about. Imagine a
specific person. It could even be a person who has already died or maybe even a person you haven’t met yet. Just
imagine who you might want to get up to speak about your life. What would you want that person to say about what
you have meant to them, what they feel you have stood for in your life? Imagine that person actually saying those
things you’d most like them to say. Really be bold here! Let that person say exactly what you would most want them
to say about you if you had totally free choice about what that would be. See if you can actually hear those words
coming out of their mouth. (Pause and allow time for the client to imagine what they would want that person to say.)

Now imagine that another person stands up. Maybe it’s your child or a friend or colleague. (List some specific people
from your client’s life.) What would you like that person to remember of what you have meant in their life? Again,
don’t hold back. If you could have them say anything, what would it be? Even if you have not actually lived up to
what you would want, let them say it as you would most want it to be. See if you can actually hear them saying what

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Standard Eulogy Exercise

you would most want them to say. Notice what it feels like to have those things said about the life you have lived and
what you have meant to this person. (Pause and allow time for the client to imagine this, eyes still closed.)

Finally, a last person stands up. Maybe this is your father, or your partner, or maybe it’s someone from your commu-
nity. (Again, list some specific people from your client’s life.) This last person agrees with everything that the other two
speakers have said, but they add something to it. What would you want this person to talk about in their eulogy of
what your life has meant? Dream big here. Remember, this was a well-lived life. An honorable life. What would this
person say in describing your honorable life? Have it be said as you would most want to hear it. Really see if you can
experience what it is like having them say those things. What would you want them to say? (Pause.)

The therapist then helps the client reorient back to the session and open their eyes.

Debrief
During the debrief, begin by asking the client what they noticed and experienced during the exercise. Questions you might
ask include:

• Who did you want to stand up?

• What were some of the words they used to describe you and the life you have lived?

• What did it feel like to hear those things said about you and your life?

• Did you notice any difference between what you would want them to say mattered to you in your life, and what you are
spending your time prioritizing or struggling with currently in the life you are actually living?

• What is getting in the way of being the person you want to be right now in this moment?

Option for Homework

Ask the client to spend some time writing out what they would want certain important people in their life to say about them
during their funeral. You might choose their children, friend, partner, or colleagues. This can be done as a way to explore their
values in relationships that may not even exist yet. For example, you could ask what they might want their children or spouse to
say about them even if they don’t have kids or a spouse yet (assuming you know that these might be relevant to the person) and
then talk about how they might be able to take a step toward those values even now.

Reference
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd
ed.). New York: Guilford Press.
Values in Therapy Eulogy Homework Handout for Clients

Eulogy Homework Handout for Clients

(Chapter 5 Tool)
Sometimes it can be helpful to reflect on the life we are creating today by looking back on it from the end. This exercise can be
a helpful way to explore what you might want to sum up your life, what you might want to be remembered for, or who or what
you’d want to have been important to you when you get to the end of it all. This exercise can also be a way to take a look at
where the current course of your life is taking you, what the end of the trajectory you are on currently might look like. This
exercise can take anywhere from fifteen minutes to much longer. You don’t need to do it all in one sitting either; feel free to
spread it across several days if that is useful.

Instructions
Take a few moments to get comfortable and centered. Do whatever you need in order to help yourself slow down and be present
to this moment. You might close your eyes for a few minutes or simply take some time to notice what is happening with your five
senses right now: what you are feeling, seeing, tasting, smelling, and hearing.

Part 1: Your Well-Lived Life

When you are ready, see if you can imagine that you have reached the end of your life. It’s been a long and very meaningful
life. It’s been a life well lived. Although you’re sad to reach the end of the journey, as you look back on the life you have lived,
you feel a sense of pride and appreciation that your life has meant something important. Take some time here to see if you can
imagine feeling good about the life you have lived once you have reached the end of it.
Now see if you can imagine that you are somehow able to attend in spirit your own funeral or celebration of life, whatever
gathering might occur of your friends and family to mark your passing. Picture the scene that would best represent your best-lived
life. You are able to see and hear everything that is happening, but others can’t see you there. Maybe you are floating above the
gathering, or maybe you are invisibly present walking among all the people there. You are watching and listening to all that is
happening. Notice what smells might be in that room, all the different sounds, notice what the lighting looks like. Now pay
attention to who is present, who you’d choose to be there at this culmination of your life. Picture their faces.
After some time of just observing this scene, some people stand up to say some words about the life you lived, what you
meant to them, and what your life stood for. See if you can imagine who you would want the first person to be to stand up to
speak for what your life, this really well-lived life, has been about. Imagine a specific person. It could even be a person who has
already died or maybe even a person you haven’t met yet. Just imagine who you might want to get up to speak about your life.
What would you want that person to say about what you have meant to them, what they feel you have stood for in your life?
Imagine that person actually saying those things you’d most like them to say. Really be bold here. Let that person say exactly
what you would most want them to say about you if you had totally free choice about what that would be. See if you can actually
hear those words coming out of their mouth.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Eulogy Homework Handout for Clients

Take a few minutes now to write down some of what you hear them say.

The person speaking was: 

What they said: 

Now imagine that another person stands up. Maybe it’s someone who knows you from a different time in your life or in a
different context from the first person who spoke. It doesn’t have to be, though. Just imagine who else you’d want to speak about
your life. What would you like that person to remember of what you have meant in their life? Again, don’t hold back. If you could
have them say anything, what would it be? Even if you have not actually lived up to what you would want, let them say it as you
would most want it to be. See if you can actually hear them saying what you would most want them to say. Notice what it feels
like to have those things said about the life you have lived and what you have meant to this person.
Again, take a few moments to write down what they said.

The person speaking was: 

What they said: 

Finally, one more person stands up. Picture who you’d want this to be. This last person agrees with everything that the other
two speakers have said before, but they also add something to it. What would you want this person to add to what has already
been said regarding what your life has been about? Remember, this was a well-lived life, an honorable life. What would this
person say in describing this life you are proud to have lived?
Once you’ve heard what they have to say, take a few minutes to write down what stood out to you.

The person speaking was: 

What they said: 


Values in Therapy Eulogy Homework Handout for Clients

Part 2: Your Current Trajectory

For this second part, you’re going to imagine a slightly different scenario. Imagine that you died today, not necessarily at the
end of a long, well-lived life. Again, people gather to mark the passing of this life that you have lived. This gathering reflects the
life you have actually lived. Notice what the gathering is like if it accurately reflected your life right now. Take a moment to look
around and see this gathering.
One unique thing about this funeral is everyone is completely honest. They aren’t just saying a bunch of nice things simply
out of respect. They are really trying to accurately remember you and what had been important to you in your life as evidenced
by your actions more than just your words.
Imagine that first person you pictured standing up. If that person were being completely honest about what they think your
life has stood for up until this moment, what you have put most of your resources toward, what would they say? What would they
say about what had been most important to you based on how you actually lived your life?

The person speaking was: 

What they said: 

The second person stands up. Again, they are looking at your life until this point and trying to accurately describe what your
actions and deeds have been in the service of. What would they say if you died today if they were being totally honest?

The person speaking was: 

What they said: 


Values in Therapy Eulogy Homework Handout for Clients

Finally, the last person stands up and, again, they have something unique to add to what has already been said. You hear
them speak to what your life has really been about up until today.

The person speaking was: 

What they said: 

Part 3: Reflection Questions

Now that you’ve done the exercise, take some time to reflect on anything you learned. Use the space below to write about
your experience. Here are questions you might ask yourself:

• What did you notice about the two different gatherings? Was there anything about those gatherings that could tell you
something about what you would ideally want to have reflect your life or what you think would reflect the life you are
currently living?

• Who was present at the two gatherings? Who wasn’t present? Is there anyone who wasn’t there that you wished would
be?

• Who did you want to stand up and speak for your life? Does this tell you anything about who or what is important to
you?

• In the ideal, well-lived life scenario, what did it feel like to hear those things said about you and that life? How did it feel
to hear the things that reflected your current life?

• What key words would have summarized what was said at the first gathering? What key words would summarize what
was said at the second gathering?

• What was similar in what was said between the two gatherings? What was different?

• After doing the exercise, what feelings, thoughts, or urges do you notice having right now?
Values in Therapy Two Sides of a Coin Exercise

Two Sides of a Coin Exercise

(Chapter 5 Tool)
Being alive means that we will suffer. But helping our clients see that there is choice in the midst of pain can change their rela-
tionship to the pain that life will inevitably bring with it. The choice that lies within pain comes from the interconnection
between pain and values.
This exercise is based on the classic ACT metaphor of pain and values being like two sides of the same coin: you cannot have
one without the other. Through it we can help our clients explore what they would want to make important even in times of
suffering.
This exercise can be done individually or in a group. You can also find another variation of this exercise and an accompany-
ing blog post at https://portlandpsychotherapyclinic.com/2012/06/pain-and-values-two-sides-same-coin-0.

Materials Needed
• An index card

Instructions
Step 1: Choose a Valued Domain or Relationship
For this exercise, it can be useful to focus on one important relationship or valued domain in the person’s life where they feel
they have lost contact with their values. They may have already identified this during the treatment planning stage of therapy.
If not, you will want to help them identify a relationship or an aspect of their life that they used to value, but from which they
find themselves pulling away. Maybe it’s a relationship they say they care about but in which they have been less engaged. Or
maybe it’s an activity they report is important to them, but they aren’t taking much action on. Brief assessment tools such as the
Valued Living Questionnaire-2 (Wilson & DuFrene, 2009), the Bull’s-Eye Values Survey (Lundgren, Luoma, Dahl, Strosahl, &
Melin, 2012), or the Values Compass (Dahl, Wilson, Luciano, & Hayes, 2005) can also be useful in helping identify a high-­
priority valued domain to target.

Step 2: Introduce the Metaphor

Once the client has identified an important valued domain or relationship they would like to focus on for this exercise, use
the following script to introduce the metaphor of pain and values being like two sides of the same coin.

Therapist: It is often the case that the relationships or areas in our life that are most important to us are also the ones that come
with the most pain. Pain and caring are like two sides of the same coin; you don’t get to have one without the other.
We suffer because we care; we feel vulnerable because there’s something that matters to us.

None of us likes to suffer, so sometimes we try to move away from the pain that is associated with these things that
are important to us. But there is a cost to avoiding that pain. When we move away from suffering, we are also often
moving away from what matters most to us, moving away from our values. When we find ourselves distancing from
those things that we once valued, maybe that’s because we are trying to avoid the pain we feel associated with those
things we cherish. We may even forget what was so meaningful about this area or relationship in the first place.

What I’m suggesting is that part of what we are doing here is learning to notice your own discomfort, your own suf-
fering, because in there you will find your values.
© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.
Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Two Sides of a Coin Exercise

Step 3: List Values

For this step, give your client an index card on which you have drawn one side of a coin on each side. Ask the client to list
what they might value, find meaningful, or feel is important to them in regard to the chosen relationship or valued domain.
(Take the note card and draw a picture of a coin on both sides of it, then give it to the client. Or if working with a group, simply pass
out blank index cards and ask them to draw a coin on both sides.)

Therapist: First, I’d like you to name your coin. On the front side of your card, write the name of the relationship or area of
living that you’ve been struggling with or that you’ve lost some sense of connection with. (Pause.)

Now take a moment to reflect on that relationship or area of your life. You can close your eyes if you’d like or just
rest your gaze on the word on the front side of your card. (Pause.)

Okay, now, under that, use the rest of the front side of the card to write down some of the values you have with
regard to that relationship or area of living. Who do you really want to be in that relationship? What are some
descriptors of how you would like to be in that area of your life? Also remember what we talked about in terms of
values—they aren’t really things, they are more like qualities of action. What are some of the qualities you would
ideally like to live out in that domain or within that relationship? (Pause.)

Now, I’d like you to take a few moments to consider a couple of actions, things that you could do with your whole
body, your hands and feet, to move in the direction of those values you just named. (Pause.)

Step 4: Contact and List Pain

Now guide your client to imagine taking one of the actions they identified as being in line with their values on the front side
of the card. You can do this through a more extended eyes-closed visualization or use the following script for a more abbreviated
version.

Therapist: (Have the client turn the card over to the back side.) Now turn the card over. On the other side of the card, write “Pain”
at the top. (Pause.) I’d like you to imagine taking one of the actions you listed on the front side of your card, one of
the actions that would move you toward what you would value. (Extended pause.)

Notice any thoughts or feelings that come up as you think about taking those actions. Are there things that show
up in your mind, your body, and your emotions? Do you notice any memories that come up when you look at this
value?

On this pain side of the card, write down what difficult thoughts and feelings might show up for you when you start
thinking about taking action toward that value. Write down the difficulty memories or sensations that occur when
you come into contact with this value.

(Have the client again sit quietly with the card, reading over what is on the front and back. Encourage them to spend some
time getting in touch with what this value means to them and also noticing the suffering that comes along with it.)

As you can see with this card, what you most care about also tends to come with quite a lot of pain. It’s natural to
want to get rid of pain. But if pain and values are inextricably linked, then working toward getting rid of the pain
also means you’re working toward getting away from what is most important to you. If these have to go away (ask
them to look at the back of the card), then you don’t get to have the value (ask them to look at the front of the card). When
you move away from suffering, it often means you’re moving away from the caring for your values that’s connected
to it. What if that’s the choice that you have?

(Have them sit with the card and look at it for an extended time.)
Values in Therapy Two Sides of a Coin Exercise

These things on the back side of your card are painful, but they are connected to something that really matters,
something potentially meaningful to you. It’s your values that dignified the difficult feelings and suffering.

Step 5: Optional Homework

The following is an optional homework you can give your client following the exercise.

Therapist: If you are willing, carry the card with you, and periodically pull it out and remind yourself of the value you picked as
most important to move toward right now. Also, read over the suffering side and notice that you are willingly carry-
ing it as you choose to carry the values that are on the flip side. Then, notice what it’s like if you take any of the
actions that are on that card. Notice what it is like if you don’t take any of the actions on the card.

References
Dahl, J., Wilson, K., Luciano, C., & Hayes, S. C. (2005). ACT for chronic pain. Oakland, CA: Context Press.
Lundgren, T., Luoma, J. B., Dahl, J., Strosahl, K., & Melin, L. (2012). The bull’s-eye values survey: A psychometric evaluation. Cognitive and
Behavioral Practice, 19(4), 518–526.
Wilson, K. G., & DuFrene, T. (2009). Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy.
Oakland, CA: New Harbinger Publications.
Values in Therapy Sasha: Building Values Prototypes Around Questions

Sasha: Building Values Prototypes Around Questions

(Chapter 6 Clinical Vignette)
Designing prototypes to provide information about specific questions can be a great way for clients to further explore a value
they might want to incorporate into their life. Below is a clinical example that illustrates how questions can help guide the pro-
totype design process.

Clinical Example: Sasha

Sasha came to therapy in a state of chronic depression. She had felt a lack of meaning and purpose in her life for several years
and described feeling a near constant state of “emotional heaviness.” However, Sasha’s description of her younger years was quite
different. She recalled of that time, “I was always laughing. People wanted to be around me, and I wanted to be around them.
There was fun and playfulness in my life.” Prior to coming to therapy, Sasha had tried many things to regain some of that sense
of play and fun in her life, including joining a kickball team, starting a game night with friends, playing practical jokes on her
colleagues at work, intentionally choosing comedies over dramas when she went to the movies, and enrolling herself and her dog
in agility classes. Sometimes these things seemed fulfilling or meaningful, but other times they fell flat in terms of improving her
quality of life.
Through our initial values exploration, Sasha identified that she thought living a life that valued play would be meaningful
to her, but she found her recent inconsistent experiences of activities that were meant to be in the service of play confusing and
discouraging. Therefore, we decided to design some prototypes to address the question “What specific aspects of play add more
meaning and vitality to my life?”
We designed several different types of play prototypes to help her test out various aspects of play, including spontaneous
versus planned play, play that involved others, play that was “silly,” play that involved being active or outdoors, and so on. Sasha
spent a few months of prototyping these various ways of living out “play,” gathering information along the way to answer her
question about what aspects of play she might choose to value. What she learned through this prototyping process was that what
provided her with the most meaning and vitality was when her play involved interacting with others as part of a team or group
effort and when the play involved physical activity. In contrast, she found that the sillier forms of play and playful activities where
she was by herself were not very satisfying to her. This information helped her decide to rejoin her kickball team, focus on dog
agility activities that were part of a team, and start a geocaching group with some friends. In contrast, she decided to give up
going to funny movies, playing practical jokes, and her game night because she learned that these ways of living out “play” didn’t
add much to her quality of life in terms of having a sense of meaning, purpose, or vitality.
By using questions to guide the prototyping process, Sasha learned that what creates meaning and purpose in her life can’t
be summed up in a single word like “play” or “fun.” Words can be good starting points for values exploration, but often clients
need to take the further step of experimenting with different ways to live out those concepts in order to know what kind of life
they would choose to create for themselves.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Daily Valuing Tracking Form

Daily Valuing Tracking Form

(Chapter 6 Tool)

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Daily Valuing Tracking Form

Daily Valuing Tracking Form

Monday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

Tuesday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

Wednesday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective
Values in Therapy Daily Valuing Tracking Form

Thursday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

Friday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

Saturday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective
Values in Therapy Daily Valuing Tracking Form

Sunday 1. How effective were you in taking actions that contributed to a better, more vital quality of living today? 3. What was one specific thing you did today that
contributed to a more vital or meaningful quality of living
1 2 3 4 5 ?
or was in the service of something that matters to you?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

2. How effective were you in making progress in the areas of your life that matter to you today?
1 2 3 4 5 ?
Not effective Slightly Somewhat Effective Very effective Don’t know
effective effective

End of the Use this space to write down any observations or questions you have in reaction to this exercise.
week review

Inspired by the Values Tracker by Pielech, M., Bailey, R. W., McEntee, M. L., Ashworth, J., Levell, J., Sowden, G., & Vowles, K. E. (2016). Preliminary evaluation of the values tracker:
A two-item measure of engagement in valued activities in those with chronic pain. Behavior Modification, 40(1–2), 239–256.
Values in Therapy Goal Rope Exercise

Goal Rope Exercise

(Chapter 7 Tool)
Goals are things that can be accomplished or obtained or milestones that can be reached. Values, on the other hand, are more
like the direction of your journey. Values establish the direction you want your life to head and the goals serve as markers to help
you navigate and let you know if you’re still on course. Goals are helpful to orient us, but not the point of the journey.
Unfortunately, goals can become disconnected from values, thereby losing what links them to something that is more expan-
sive or offers more overarching meaning. One of the downsides of being rigidly focused on goals in the absence of the larger
values context is that goals pull us out of the present moment. Goals are always in the present or the past. When we are focused
on achieving a goal, we are focused on getting to some place off in the future. That’s how goals function. As soon as we have
accomplished a goal or met a milestone, it is immediately in the past and we are looking back at it.
While clients often understand this conceptually, as with many things, it’s often helpful for them to gain some experiential
practice. The following is a clinical vignette of an experiential exercise designed to help a client contact the past/future quality
inherent in goals.

Therapist: (asks the client to stand and places a rope or some other object at the other end of the room from where the client is standing)
Okay, so let’s say you had a goal of crossing this rope. Where is the rope in relation to where you are right now?

Client: It’s in front of me.

Therapist: Right. Now let’s say you make progress toward your goal. Take one step toward the rope. (Client steps toward the rope.)
Where is your goal now?

Client: It’s still in front of me, but it’s closer.

Therapist: Yep, you made progress, but the goal is still in front of you. Okay, let’s say you’ve been very successful, making prog-
ress toward your goal. Take another step forward. (Client takes a step toward the rope.) Where are you focused now
when you’re focused on your goal?

Client: Well, it’s still in front of me so I guess I’m focused out there.

(At this point the therapist continues asking the client to take steps toward the rope, each time asking where their goal is.
Finally, once the client is about to reach the rope, the therapist continues…)

Therapist: So now the goal is right in front of you. Imagine you finally achieve your goal and cross the rope. (Client steps over
the rope.) So now where is your goal (pointing to the rope that is now behind the client)?

Client: It’s behind me. I accomplished it.

Therapist: Exactly! That’s how goals work. They are either in the future, someplace you’re trying to get to, or they are in the
past. So, one of the trade-offs of always focusing on pursuing goals is that it means you are always focused on the past
or the future and aren’t really in the present moment. I wonder if it’s kind of like that for you. Do you often feel like
you’re focused on accomplishing something in the future but as soon as you reach it, it seems to fade quickly into the
past and you’re on to pursuing the next thing that’s in the future? What is that like for you?

You can then go on to talk about how values can provide a sense of consistency and integrity to our lives in a way that iso-
lated goals that are disconnected from overarching values cannot.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Exploring Your Own Cultural Context

Exploring Your Own Cultural Context

(Chapter 8 Tool)
All of us, regardless of our sociocultural background, have a limited perspective. Often, we aren’t even aware of the perspective
we are coming from or the potential biases that may result from it. One way to begin to consider the ways in which our cultural
context has shaped our experience of the world is by exploring issues of privilege and power. What follows is a list of questions
designed to help you explore your own sociocultural context and any potential associated privileges or biases.
Take some time to reflect on the following questions. However, in doing so, see if you can approach this with a sense of
curiosity and self-compassion rather than judgment or self-criticism. It can be scary to explore our own biases and difficult to be
open to the limits of our own perspective. It can also be painful to acknowledge privilege and inequity. However, in taking the
time to do this, you are making a statement about what matters to you. This is hopefully in the service of your values. Approaching
this with a sense of compassion (both to others and yourself) will likely result in you being more open to learning what there is
to be learned from this.

• How would you describe your gender identity? Has the way you would describe your gender ever changed for you? How
much time have you spent considering or questioning your gender? Has anyone else ever questioned your gender? How
have these experiences shaped the ways you express your gender identity?

• Have you always had a secure place to live in? Have you ever been worried about becoming homeless?

• What was your socioeconomic status (SES) growing up? Did most of the people you grew up around fall into that same
SES? What is your SES now? How many people do you know well who fall into a significantly higher or lower SES than
you? How do issues related to class affect the way you experience the world and what you do with your life?

• Have you ever felt fear or embarrassment to be seen in public with a person you are in a romantic relationship with? Have
you ever felt the need to hide or deny aspects of your sexuality out of fear or shame?

• When you were growing up, did you share the religious or spiritual beliefs of the dominant culture? Are the religious
ideas that are included in your country’s pledge of allegiance, oaths, laws, common sayings, holidays, or printed on your
country’s money consistent with your views or beliefs? How did these experiences affect you?

• Have you ever been asked “What are you?” in reference to your race, ethnicity, or gender?

• How many people in your family graduated from high school? College? Did you have people in your family who were able
to guide you as you considered applying to colleges? How might these experiences have shaped you?

• How many people do you consider to be a part of your family? Are the people you consider family all blood relatives? Do
you all share the same race?

• How many languages were spoken in your household growing up? Have you ever lived in a place where your preferred
language was not the dominant language?

• How often have you moved in your life? Have you ever lived in a place where the dominant culture was very different
from your own?

• How often do you see people that look like you do (ability, age, weight, race, gender) portrayed in positive ways in the
media? How often do you see people that look like you portrayed in negative ways in the media?

• What kinds of erroneous assumptions do people make about your beliefs, preferences, or practices? How often does this
happen? Do you correct them? Why or why not?

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Exploring Your Own Cultural Context

• Have you ever been denied a job or housing because of your age, race, ability status, gender identity, or criminal
background?

• Are there aspects of your body that are commonly judged negatively by others in your culture? If so, how has that
affected you and how you interact with others?

• How often have you been the only person of your race in a room? What about the only person with your gender
identity?

• Reviewing your answers above, what implications might these experiences have for your view of the world? How might
these experiences affect how you see others and how you view the world?

• What are any other sources of privilege your cultural context might afford you?

• What are any other sources of marginalization or oppression you might experience because of your cultural context?

• Given your values and what is most important to you, what is one thing you would choose to do as a result of what you
learned from this exercise?
Values in Therapy Value of the Day Exercise

Value of the Day Exercise

(Chapter 8 Tool)
This exercise is based, in part, on the Trying on a Value exercise (Dahl, Lundgren, Plumb, & Stewart, 2009). It is designed to
help give clients an opportunity to practice enacting a potential value for a short period of time and collect some data to see what
living a life in the service of certain values would be like. This can also be a helpful exercise for clients who report that they don’t
have any values or don’t know what they value, as they can simply choose some values to “try on” as it were, without having to
make a commitment to any of them. In this same way, it can also be helpful for more perfectionistic clients who are having dif-
ficulty taking action for fear of choosing the “wrong” value.

Instructions
Step 1: Select Five to Seven Potential Values to Practice
This exercise is best used after a client has already done some preliminary values exploration exercises, such as the Values
Card Sort exercise (see http://www.newharbinger.com/43218), in which they have begun to identify some ideals or values they
may want to enact as part of a meaningful, well-lived life. Remind the client that the values they use for this exercise don’t neces-
sarily need to be the ones they are certain are most important to them. These are just “tester” values. In fact, if clients have
difficulty narrowing down potential values, they can even experiment with enacting randomly chosen values. The point here
isn’t to get it “right.” The point is for the client to get practice intentionally enacting values and tracking the consequences so
they can make more informed decisions about what they would choose to value.

Step 2: Create Daily Values Cards

Once the client has identified five to seven values they want to practice during the week, write each of those values down
on a separate index card. These are their “daily values cards” they are going to choose from throughout the week. Often, during
the early stages of values exploration, clients will have simplified their values into individual words like “patience” or “kindness”
or “playfulness.” These are totally fine to use for the daily values cards. However, don’t feel you need to limit your client to spe-
cific words. They can use phrases or even images or metaphors, anything that seems to capture the quality of action they are
wanting to practice. Coming up with images, more detailed descriptions, or metaphors to describe potential values can even be
a part of the values exploration process for the client.

Step 3: Identify Potential Values-Consistent Behavior

After the client has identified several values they want to practice, help them identify some behaviors that they feel might
be consistent with each value. Some questions you can use to help them identify specific values-consistent behaviors could
include:

• Who do you know who embodies this value? Describe what they are like. What might they do on a typical day?

• If you were an actor whose role was to play someone who was X (with X being the value), what things might you do as
that character?

• What things would you do differently at work if you were trying to enact X (one value) as opposed to a day when you
were trying to enact Y (a different value)?

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Value of the Day Exercise

You can write down some of these behaviors on the back of the daily values cards as a reminder for the client. Once your
client has their daily values cards, they are ready to practice.

Step 4: Select a Value for the Day

Every day, ideally first thing in the morning, the client chooses a value they are going to practice for that day. The value can
be randomly chosen by putting all the daily values cards in a jar and pulling one out at random that will be the value they focus
on for that day. Alternatively, the client can intentionally choose which value they would want to focus on after spending a few
minutes each morning reflecting on all of the five to seven values. It can be helpful to have the client carry around that day’s
value card with them throughout the day, periodically looking at it as a reminder of their intention for the day. Clients can also
set reminders on their phone that will help cue them to remember the value they are choosing to focus on.

Step 5: Notice What It Is Like to Choose

Tracking the consequences of choosing and living out a value is an essential element of this exercise. The client is gathering
data that they will use to make more informed values decisions. Each morning after the client has selected their value for the
day, have them track what thoughts, feelings, sensations, or urges they notice after selecting the value. Do they feel inspired?
Daunted? Bored? Disappointed they didn’t select a different value? Do they have thoughts about whether or not they will enjoy
enacting that value? Do they have urges to avoid the task?

Step 6: Enact the Value

Now it’s time to practice. The idea here is that throughout the day the client is intentionally looking for ways to embody the
value they have selected. Values are always immediately available to us. Therefore, we aren’t so much asking the client to neces-
sarily do different things as we are encouraging them to do the normal activities of their life in a different way, a way that would
reflect a particular value. For example, if the value of the day is “generosity,” your client doesn’t necessarily need to go out and
volunteer to serve at a soup kitchen that day. While they may decide to incorporate more of those types of activities into their
life as time goes by, right now the idea is help them see how they could embody generosity as they are doing their normal daily
activities at work, at home, with friends, with people they pass on the street, and so on. It’s more about doing things differently
than it is necessarily doing different things.

Step 7: Track the Consequences

There are several ways the client can track the consequences of engaging in valued behavior. The Daily Valuing Tracking
form (http://www.newharbinger.com/43218) is an easy way for clients to record their daily experiences of valued living. If the
client is willing, they can also do more extensive data collection, spending a few moments at the end of each day writing on one
or more of the following reflection questions:

• Did my actions make a positive difference in an area of life that matters to me? Did my valued actions make a difference
to the people who are important to me? If so, what kind of a difference did my valued actions make?

• What thoughts, feelings, and sensations did I have while I was enacting this value?

• How was today different because I was enacting this value?

Values in Therapy Value of the Day Exercise

• As I look back on having spent a day enacting this value, would I say that living in this way was meaningful or worth-
while? Was today more meaningful or a more well-lived day because I was behaving in a way that was consistent with
this value or not?

• What would it be like if I continued living out this value over the course of a month, a year, a lifetime?

• If I were looking back on a life in which I had consistently lived out this value to the fullest, how would I feel about
having lived that life? What thoughts or feelings might I have as I reflect back at the end of having lived that life?

• If I decided to not continue valuing in this way, what thoughts or feelings might I have a year from now looking back on
a year of not having lived out this value? What might I think or feel at the end of my life as I look back on a life of not
having lived out this value?

Step 8: Repeat
Repeat steps 4 to 7 each day for a week (or until the next therapy session). Be sure to review the data your client collected
at the end of each practice day during their next session.

Reference
Dahl, J., Lundgren, T., Plumb, J., & Stewart, I. (2009). The art and science of valuing in psychotherapy: Helping clients discover, explore, and
commit to valued action using acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.
Values in Therapy Before-Session Compassion Exercise

Before-Session Compassion Exercise

(Chapter 9 Tool)
This tool, which is based on an empathy exercise originally developed by Vilardaga, Levin, and Hayes (2007), is a quick
perspective-­taking exercise you can use between sessions that can help you reconnect with what matters most to you in your
work. The act of extending compassion and empathy, both to your client and to yourself, before the session even begins can help
you stay as connected with your values for your 6 p.m. client as you are with your 9 a.m. client.
The exercise only needs to take a couple of minutes and all you need for it is a quiet place, like your therapy office. You don’t
necessarily need to give a response to the questions in the exercise; instead, just give yourself four to five minutes to think
through them. There is also an audio version of the exercise available at http://www.newharbinger.com/43218.
Before you go out to the waiting room to pick up your client, have a seat, put down your agenda, set aside trying to figure out
what you’re going to do in the session, and allow yourself a few minutes to reflect on the questions below:
1. As you are seated in a quiet place, take a few seconds to picture the client who is sitting outside your office right now.
Imagine what it might be like for them right now. What might they see, hear, or smell as they are waiting outside your
office?
2. As you do this, really try to experience things from the client’s perspective. Imagine what thoughts, feelings, and judg-
ments this person might be having right now as they are sitting in the waiting room. Notice any urges or longings they
might have as they are waiting for you to come out to get them.
3. Taking a step back from the content of those thoughts, feelings, and judgments, see if you can connect with this person
as a conscious being who is more than the content of those experiences, a person who is more than the content of their
suffering, more than their history. Like you, the person sitting outside your office right now has things that matter to
them, people they care about, and people that care about them, even if they sometimes have a hard time connecting
with that, just like you might at times. They long to have a life that is meaningful, a worthwhile life.
4. Now see if you can connect with what it might be like for this person to experience the thoughts, feelings, judgments,
and urges they are experiencing right now. Notice that even if some of those experiences and sensations are uncomfort-
able for them, they are still choosing to be here, to do this work with you. Could it be that there is something in this work
that matters to them, something important to them? What might that be?
5. Now shift back to what you are experiencing right now as you prepare to see this client. Take a moment to notice some
of the thoughts, feelings, or judgments you might be having about this client and about yourself. What urges or longings
show up for you in this moment?
6. Recall other times when similar thoughts, feelings, and judgments have come up for you at different times, with different
clients, months or years ago, and notice how they are happening here, in this very moment with this client. And yet,
even though you have experienced these thoughts, feelings, and judgments many times throughout your life, see if you
can connect with your sense of conscious awareness, the you that is more than the content of those experiences. You,
just like your client, care about things deeply, have things that matter to you in this work that are about more than these
thoughts, feelings, or judgments that are visiting you.
7. Finally, take a moment or two to reflect on the fact that even though some of the experiences you are having right now
may be uncomfortable, by this very action of pausing to reflect on your values, you are taking a step toward something
that is important to you. What might that be? If you could choose, what would you have this next hour with this client
be in the service of? How would you want to be with this client if you were free to choose any way of being? If you were
transported in time to the end of the session, what would you like this client to have taken from this time with you?
What would make this a well-lived hour of your life?

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy Before-Session Compassion Exercise

8. Now bring your attention back to the room. Take a moment to just notice your different bodily sensations…the various
sounds…and the objects around you. And go greet this person you will be sharing the next bit of your life with in the
service of something that matters.

Reference
Vilardaga, R., Levin, M., & Hayes, S. C. (2007, November). A comprehensive review of perspective taking procedures in the psychological
literature. In R. Vilardaga (Chair), A psychological analysis of perspective taking: Research and applications informed by relational frame
theory. Symposium presented at the 41st Annual Convention of the Association for Behavioral and Cognitive Therapies, Philadelphia,
PA.
Values in Therapy Before-Session Values Practice

Before-Session Values Practice

(Chapter 9 Tool)
Being a therapist is hard. We spend hour after hour trying to be emotionally connected and present, often in the face of tremen-
dous suffering. It can be difficult to remain in contact with what is most important to us in the face of all that pain. It’s easy to
just let the autopilot kick in. What follows is a ritual I have found helpful as I transition between sessions. This practice, which
can be done in as little as one minute and is something I do before every client I see, helps me reconnect with my values and who
I want to be with those I serve. Here is the practice as I do it, but feel free to tailor it to whatever works best for you.
1. Sit down in your therapy chair and close your eyes, letting all the busyness and preparation you have been doing fade
away. Allow yourself to picture the client you are about to meet with. See them in your mind’s eye as they are sitting
there in the waiting room outside your door.
2. Now imagine what that client might be feeling or thinking as they are waiting to meet with you. Reflect on the idea that
there is something important in this next hour for the client, something they are hoping for.
3. Then, take a moment to connect with this person as a larger conscious being and with the common humanity you both
share. You might do this by picturing someone else who cares for this client. It could be their spouse, their child, their
pet, or their parent. Try to picture what that loved one looks like as they are looking at your client, and what they would
wish for your client, this person they care about.
4. Finally, come back to the present moment and recognize that you have this one hour to be with this individual person,
this person who thinks and feels and suffers and loves and is loved, just like you. Then reflect on this: Given this oppor-
tunity, how do I want to be toward this person over the next hour? This is the key part. You are not reflecting on what you
want to do or any particular agenda you want to cover in the session. Rather, you are reflecting on who you want to be
with this person, what qualities you would choose to embody in this one hour that you have. At the end of the session,
even if all your interventions fall flat, even if there is little objective “progress” made, what kind of person would you have
most wanted to be with this individual? What way of being would have made this hour worthwhile regardless of the
outcome? Once you have connected with that, you can go out to pick up your client and begin your work together.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy How Would You Choose to Serve?

How Would You Choose to Serve?

(Chapter 9 Tool)
This exercise is about helping you get in contact with your work-related values. For this exercise, it’s good to be in a quiet place
and you will need something to write on. You may find it helpful to close your eyes during the visualization portions of the exer-
cise. There is also an audio-guided version of the exercise at http://www.newharbinger.com/43218.

Instructions
Begin by getting settled into a comfortable position in a quiet space. Take a couple of minutes to become aware of the you that
is here right now. Maybe notice the sensation of your feet on the ground, the feel of your chest rising and falling with your breath,
the air on your skin. Just spend a few minutes here getting present to being right here and now.
Now notice all the things that went into you sitting here right now doing this exercise, the choices you made and the steps
you took to arrive right here, right now. You had to set aside time to do this exercise. Maybe you had to move things in your
schedule that were important to you. Going back even further, you had to make choices that led you to this place where you are
reading this book about values and doing an exercise about what is most important to you as a therapist. And see if it isn’t true
that all of those activities that got you to this point of doing this exercise today are part of a larger pattern that is your career.
Just take a moment to reflect on all the steps you have taken to get to this present moment in your career.
Now see if you can bring yourself back to that time when you first began your career. Picture what you looked like at that
time, the younger and less experienced you. See if you can get in contact with what this younger, less experienced you wanted
this work to be about. What was important to that therapist who was just starting out in this work? Don’t answer too quickly,
just sit with that question for a bit. See if you can connect with the you that was there back then at the start of your career and
what really mattered to that person, even if it’s something you feel like the you here now might have lost touch with in some ways.
Just let your attention rest on that for a bit with curiosity.
Now, as if you could fast-forward the movie, see if you can picture yourself in the future, at the end of your career. It may be
many years from now or maybe not that far in the future. Whenever it is, see if you can imagine the you who has come to the
end of your career and is looking back on it. And as you are reflecting back on this career you have dedicated so much of your
life to, see if you can connect with all the people whose lives you may have touched. Hundreds, maybe even thousands of clients.
Think of all the colleagues you will have had, those you have consulted with, trained with, people who, like you, have committed
a big part of their life to helping others who are suffering. Some of those clients and colleagues are part of your life now. Others,
you are no longer in contact with, but they were there for some part of your journey and you theirs. Take a moment to notice
whether there are things that you feel proud of as you look back on all these people who have been a part of this career you’ve
had. Maybe there are regrets as well that you notice as you look at all these faces. Regret can also tell us something important
about what matters to us, so just see if you can be curious about those regrets, without judgment. Just take a few moments to be
curious about whatever may show up for you as you look around this sea of people who have all been a part of this journey you
call your career.
As you think about all the people you have worked with on this journey of your career, choose one specific person, one you
care about. Maybe it’s a client you had long ago that you still think about. Maybe it’s someone you are working with now that
has a special place in your heart. Maybe it is a colleague with whom you feel connected in this work or a mentor who really had
an impact on shaping who you are.
Whoever you choose, imagine yourself in your therapy office sitting across from that person. See their face, their posture.
Notice what it feels like to be looking at this person you care about. Notice that this person suffers just like you. This person has
people they care about, just like you. This person has hopes and dreams, just like you. And just like you, this person longs to be
happy or be at peace but finds peace or happiness elusive much of the time.

© 2019 Jenna LeJeune and Jason B. Luoma / New Harbinger Publications.

Permission is granted to the reader to reproduce this form for personal use.
Values in Therapy How Would You Choose to Serve?

As you are sitting here with this person, who is like you in many ways, let your attention rest on these questions:

• How would I choose to be toward this person?

• Given what matters to me about this work, how would I be with this person?

• How would I want this person’s life to be impacted by me being in it?

• If I were my very best self, how would I be interacting with this person right now?

• What might any of this tell me about what is most important to me in my work?

Take a few minutes with your eyes closed, picturing this person you’ve chosen to focus on while you are reflecting on these
questions. Notice what shows up for you as you are thinking about being with this person in this way. Notice any feelings, urges,
or evaluations.
Allowing those images to fade away, and then take a moment to notice your body in the chair again.
Take between five and ten minutes to write about what showed up for you in the exercise and any responses that you had to
the reflection questions.