On values and their On values and their measurementmeasurement

Kevin E. Vowles, Ph.D.Kevin E. Vowles, Ph.D.University of BathUniversity of Bath

Association for Contextual Behavioral ScienceAssociation for Contextual Behavioral Science01 July 200901 July 2009

OverviewOverview

• Some thoughts on values Some thoughts on values measurement:measurement:

– In practiceIn practice

– Via assessment (i.e., standardized Via assessment (i.e., standardized questionnaires)questionnaires)

My observationsMy observations• Values are devilishly complex.Values are devilishly complex.

– The answer to, “What matters?” is under The answer to, “What matters?” is under the influence of multiple complex the influence of multiple complex behavioral processes, some beneficial, behavioral processes, some beneficial, some not.some not.

– Values work is best begun early and Values work is best begun early and continued throughout the entirety of continued throughout the entirety of treatment.treatment.

– Values work must be done both directly and Values work must be done both directly and with subtlely, a contradiction to be sure.with subtlely, a contradiction to be sure.

Most Important Skill?Most Important Skill?

• ListeningListening

– Specifically, Specifically, reflective listeningreflective listening..

– Tests a hypotheses: “Is this what you Tests a hypotheses: “Is this what you meant?”meant?”

Ways of ReflectingWays of Reflecting• RepetitionRepetition – Repeat an element – Repeat an element

– ““You want some help.”You want some help.”

• RephrasingRephrasing – Repeat with synonyms – Repeat with synonyms– ““Sounds like you think more assessment and Sounds like you think more assessment and

more tests will help.”more tests will help.”

• Reflection of feelingReflection of feeling – paraphrase – paraphrase emphasizing emotional dimension.emphasizing emotional dimension.– ““This sounds as if its very important to you.”This sounds as if its very important to you.”

• ParaphraseParaphrase – best guess at meaning. – best guess at meaning.– ““You are hoping that one more test or You are hoping that one more test or

evaluation will clear all of this up.”evaluation will clear all of this up.”

Exercise - Part 1Exercise - Part 1

• Speaker:Speaker:– Think of something you want to change, but Think of something you want to change, but

still have some ambivalence about.still have some ambivalence about.– Perhaps something related to a health Perhaps something related to a health

(smoking, diet, exercise), recreation (TV (smoking, diet, exercise), recreation (TV watching, hobby), or work.watching, hobby), or work.

• Listener: Listen reflectively.Listener: Listen reflectively.

• Speaker: Can respond with elaboration.Speaker: Can respond with elaboration.

Listening TipsListening Tips• Guess at what they mean.Guess at what they mean.

– (It’s ok to be wrong)(It’s ok to be wrong)

• Make a Make a statementstatement, not a question., not a question.– ““Sounds like . . . ”Sounds like . . . ”– ““You are wondering if . . . ”You are wondering if . . . ”– ““You are feeling (thinking, hoping, etc.)”You are feeling (thinking, hoping, etc.)”– Express empathyExpress empathy

• Can start w/simple reflections and Can start w/simple reflections and then use advancedthen use advanced

Exercise – Part IIExercise – Part II

• Speaker – Don’t explain why; simply Speaker – Don’t explain why; simply state what this change would do for state what this change would do for you.you.

• Clinician – Listen, Reflect, Ask for Clinician – Listen, Reflect, Ask for clarification.clarification.

Possible IdeasPossible Ideas

• Why is this important to you?Why is this important to you?• If you did that, what would that allow If you did that, what would that allow

you to do?you to do?• Please:Please:

– Slow downSlow down– Recognize that this is likely to be Recognize that this is likely to be

importantimportant– Notice that there is a human being across Notice that there is a human being across

from youfrom you– Listen, don’t solveListen, don’t solve

An example of measuring An example of measuring valuesvalues

• Chronic Pain Values InventoryChronic Pain Values Inventory

– Ratings of importanceRatings of importance

– Ratings of successRatings of success

– Also allows for discrepancy score to be Also allows for discrepancy score to be calculated calculated • i.e., (importance) – (success)i.e., (importance) – (success)

The impact of The impact of lessless struggling struggling and and

moremore maintenance of life maintenance of life directiondirectionBetter:

– Current emotional and physical emotional and physical functioningfunctioningMcCracken & Yang, 2006, Pain; Vowles et al., 2008, Pain

– FutureFuture emotional and physical emotional and physical functioningfunctioningMcCracken & Vowles, 2008, Health Psych

– ImprovementsImprovements in emotional and in emotional and physical functioning physical functioning three months three months after treatmentafter treatment

Vowles et al., 2007, Eur J Pain; Vowles & McCracken, 2008, J Consulting & Clin Psych

““You desire to know the art of living, You desire to know the art of living, my friend? It is contained in one my friend? It is contained in one phrase: make use of suffering.”phrase: make use of suffering.”

Henri-Frédéric Amiel (1821-Henri-Frédéric Amiel (1821-1881)1881)

k.vowles@bath.ac.uk

www.bath.ac.uk/pain-management/