Acceptance and Commitment Therapy in a Ugandan Context: Exploring Values Guided Action

Today provided an opportunity to deliver an ‘Acceptance and Commitment Therapy’ (ACT) workshop in Kampala for a range of counsellors and psychologists. ACT is a third-wave psychological therapy that aims to help people to clarify their values and to engage in behaviours that are consistent with these values, as they hold doubts, fears and concerns that might arise lightly. Previous posts in this blog attest to the efforts I have made in conjunction with ‘commit and act’ (http://commitandact.com) to build capacity for ACT in Sierra Leone and Uganda. We have published research that has highlighted the feasibility of training non-specialist workers in delivering ACT in low resource settings (http://eprints.gla.ac.uk/117762/). A recent book chapter entitled ‘commit and act in Sierra Leone’ (http://link.springer.com/chapter/10.1057/978-1-137-39510-8_31), published in ‘The Palgrave Handbook of Socio-cultural Perspectives on Global Mental Health’ (http://link.springer.com/book/10.1057/978-1-137-39510-8), reports on the potential value that ACT might offer for building capacity for mental health in low resource settings.

 

In August 2014, I delivered the first ever ACT workshop in Uganda. In subsequent years, other trainers including Igor Krnetic and Joe Oliver have delivered workshops. Dr Rosco Kasujja has done a great job at keeping momentum going with the development of ACT in Uganda. It was great that Rosco was available to co-facilitate. It is always a joy to work with Rosco. Our styles of working complement each other and together we form what our friend and colleague Richard Fay refers to as the ‘Ros-collective’!

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Rosco and myself – ‘The Ros-collective’

 

The workshop provided an opportunity to catch up with some people that I met during my visit to Kampala in 2014. In addition, I was also honored that colleagues based in Lira who had assisted with a research study we conducted there in 2015 had also made the long trip down to Kampala. This group included Fr Ponsiano who was so crucial to the completion of that research project. I had been very much looking forward to seeing him again.

 

There were a total of 30 attendees present at the workshop who spoke a total of 6 different mother tongue languages. In addition, to Luganda (N = 10), which has been highlighted in previous blog posts, individuals reported the following languages as their mother-tongues:

  • Lango (N = 9) is spoken by 2.1 million people according to the 2014 census – who are concentrated in the Northern region of Uganda. Lango shares lexical similarity with the Acholi language that has also featured in recent blog entries.
  • Runyankore-Rukiga (also known as Chiga; N = 7) is a Niger-Congo language spoken by 2.4 million people in Uganda.
  • Ateso (N = 2) (also known as Teso) is a Nilo-Saharan language spoken by 2.4 million people across the country.
  • Lumasaaba (also known as Masaaba; N = 1) is a Niger-Congo language spoken by 1.7 million people.
  • Runyoro (also known as Nyoro; N = 1) is a Niger-Congo language spoken by 970,000 people in Uganda.

In advance of the workshop, the attendees had been invited to participate in a research survey that investigated how notions of overcoming difficulties are captured in their language, poems and songs. After completing the survey questions individually, members of the language groups were allowed to discuss their responses and then complete an additional response sheet relating to the consensus of the group regarding their responses.

 

The completion of the research activity proved to be a helpful ice-breaker for the workshop that followed. It served to ground the subsequent focus on therapeutic strategies aimed at ameliorating distress in the context of the languages that they use on a daily basis to conduct their work. This particular workshop focused on ‘Values Guided Action: An ACT Approach’. The workshop was intended to be experiential with attendees having the opportunity to apply the material to their own lives, so that they might be able to share the approaches with people they are supporting in a more authentic way. The attendees engaged well with the practices/exercises that were included. I was pleased with the level of interaction that the attendees had with me, and the insightful questions that they asked. I am very excited and optimistic about the opportunities that exist for ACT to be tailored to Ugandan cultural and linguistic contexts. I hope that the work that we are undertaking as part of the current research will help to inform this.

 

At the end of the one-day workshop, Fr Ponsiano provided warm words of appreciation to myself, Rosco and Cliodhna for organizing and delivering the workshop. Not for the first time, I was struck by the remarkable grace that Fr Ponsiano embodies. His poise, considerate manner, and eloquence as an orator, are plain for all to see. As he expressed his gratitude, I was able to be deeply present with the reasons why I do the work that I do – to share insights that I have learned, whilst benefitting greatly from the warmth, wisdom and sense of connection that others are kind enough to share with me. I am pleased to say that Fr Ponsiano is planning to commence a PhD in the coming months exploring conflict transformation in Uganda. He, more than most, is well placed to make an important contribution to this area of work.

 

The reflections of Cliodhna Cork (Research Assistant and MSc Global Mental Health graduate):

 

It was great to sit in on the ACT workshop, delivered by Ross and Roscoe. As I am not a qualified therapist, it was primarily useful for my own daily practices as well as being an education into using this form of therapy in varied settings. There were many insights from practicing therapists on using ACT to address trauma, particularly in Northern Uganda where entire communities have quite recently experienced deeply traumatic events. I was inspired by the huge sense of social responsibility among these therapists and students, and the lengths they go to in order to provide often voluntary services to those most in need of it. It was encouraging to see how a form of therapy primarily developed in the USA and Europe could be meaningfully and successfully used in a different context. This is due in part to ACT’s focus on a person’s values without enforcing predetermined goals or values onto them. Thus ACT can be easily adapted to each therapeutic relationship and context. That said however, while doing group work with other attendees I was struck by the realisation that despite all of our vastly different backgrounds, ages, and languages there seem to be some basic values that are almost universal: valuing family and social relationships came up time and time again, as well as living an ‘honest’ life.

I spoke to some psychology graduates and masters students who mentioned the lack of state funded jobs available to them. However, there seemed to be glimmers of hope, with one student saying that the state was slowly investing more in clinical psychology based jobs. Many engaged in voluntary work with NGOs or non-profit organisations both to get relevant experience and to give back to their communities. One example is Faces Up whose Facebook page can be found here: https://www.facebook.com/FacesUpUganda/ while some were even involved in founding their own non-profit organisations such as ‘Special Minds Initiative’ (https://www.facebook.com/SpecialMindsIni/) co-founded by Hillary Mutatiina.

 

I was grateful to have had the chance to meet Fr. Ponsiano, who Ross had spoken about with admiration during the Global Mental Health masters. It is clear that he is a man of great dignity and I wish him every success in his plans for the future.

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Workshop attendees

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