18 Graduate Student Journal of Psychology 2018, Vol. 17 Copyright 2018 by the Department of Counseling and Clinical Psychology Teachers College, Columbia University The Process of Valuing and Subjective Well-Being for Trainees Robin Grumet, Marilyn Fitzpatrick, Lauren Yildirim, Bethsheba Ananng, and Megan Knoll McGill University The current qualitative research investigated the process of valuing from an Acceptance and Commitment Therapy perspective, as well as the influence of this process on subjective well-being in novice therapists. Sixteen MA Counseling Psychology students participated in a three-hour workshop that involved didactic and experiential components aimed at facilitating values clarity and values congruent living. A semi-structured interview explored values clarity, behavioral congruence, as well as well-being, including both mood and life satisfaction. Consensual Qualitative Research was used to analyze the interview data. Findings indicated that the values clarification process is complex and challenging, and that structured interventions support this process. Work demands were a particularly salient barrier to valued living for trainees. The valuing process influenced mood more than life satisfaction and was related to eudaimonic, but not hedonic pursuits. Implications for theory, practice, supervision, and future research are provided. A central aim of psychology is to alleviate psycho- logical distress (Seligman & Csikszentmihalyi, 2000; Duckworth, Steen, & Seligman, 2005). The absence of distress however, is not synonymous with well-being (Ryan & Deci, 2001; Duckworth et al., 2005). Well-being can protect against the development of clinical disorders (Joseph & Wood, 2010). The field of Positive Psychology has begun to investigate the pathways to foster happi- ness or subjective well-being (SWB) (Duckworth et al., 2005; Seligman & Csikszentimihalyi, 2000; Schueller & Seligman, 2010). SWB is an individual’s perception of wellness and includes positive affect, minimal negative affect, and high levels of life satisfaction (Diener, 2000). Research suggests that SWB is associated with positive physical and psychological health outcomes. Findings from a recent meta-analysis of randomized controlled studies in Positive Psychology interventions suggest that preventative interventions that foster SWB can also minimize depressive symptoms (Bolier, Haverman, Westerhof, Riper, Smit, & Bohlmeijer, 2013). Research also suggests that using positive interventions to augment SWB can protect against the development of depression and other psychological disorders including generalized anxiety disorder and panic disorder (Keyes, Dhingra, & Simoes, 2010; Joseph & Wood, 2010). There is also ample evidence that high SWB is related to good physical health and longevity (Diener & Chan, 2011). Although it is heritable to some degree, evidence from Positive Psychology suggests that SWB is malleable and can be augmented (Tay & Kuykendall, 2013). Determining ways to foster SWB is gaining empirical attention in the field of Positive Psychology (Giannopoulos & Vella-Brodrick, 2011; Tay & Kuykendall, 2013). Seligman has identified three distinct pathways to SWB (Duckworth et al., 2005; Schueller & Seligman, 2010). The first, pleasure, consists of experiencing plea- sure and positive emotions (Duckworth et al., 2005). The second is engagement, which involves immersing oneself in activities that are intrinsically rewarding (Duckworth et al., 2005; Schueller & Seligman, 2010); engaging fully can lead to the experience of flow, which is a mental state characterized by total absorption in an enjoyable and rewarding activity (Csikszentmihalyi, 1990). The third pathway, meaning, refers to belong- ing to and contributing to causes that transcend the self (Duckworth et al., 2005). A sense of purpose and Override (Hidden running head text): Grumet, Fitzpatrick, Yildirim, Ananng, Knoll ACT Value Clarification Keywords: Acceptance and Commitment Therapy; values clarification; values behavior congruence; subjective well-being; mood; life satisfaction Please address correspondence regarding this article to: robin.grumet@mail.mcgill.ca 19 ACT VALUE CLARIFICATION direction in life leads to the creation and pursuit of meaningful goals and results in well-being (Frankl, 1997). Although all three elements are associated with SWB, Positive Psychology research suggests that engage- ment and meaning have more robust relationships with SWB than pleasure (Schueller & Seligman, 2010; Vella- Brodrick, Park, & Peterson, 2009). The underlying principle of most positive psychol- ogy interventions is that SWB is enhanced by positive goals and intentional activities (Tay & Kuykendall, 2013) and that it is trainable (Lyubomirsky, Sheldon, & Schkade, 2005; Sheldon & Lyubomirsky, 2007). Interventions targeting behavioral change are at the heart of evidence-based approaches such as cognitive behavioral therapy (CBT). More recently, intervention research has focused on interventions linking behavioral change to meaning and purpose. One example of such an approach is Acceptance and Commitment Therapy (ACT), which is a recently developed third wave behavioral therapy (Hayes, Strosahl, & Wilson, 1999). ACT helps clients learn to accept and embrace difficult experiences in order to live a life in service of their personal values (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Values are “chosen quali- ties of purposive action that can never be obtained as an object but can be instantiated moment by moment” (Hayes et al., 2006, p. 9). Unlike goals, which can be achieved, values can never be fully attained but can be continuously expressed in moment-to-moment behav- ior. Values are freely chosen and intrinsically motivating; they are not adopted from a desire to please others or avoid negative consequences (Ciarrochi, Fisher, & Lane, 2010; Plumb, Stewart, Dahl, & Lundgren, 2009; Wilson, Sandoz, Kitchens, & Roberts, 2010). ACT theory posits that value-based actions are associated with positive physical and psychological health outcomes and discrepancies between values and behavior have detrimental effects on health (Plumb et al., 2009). Research on ACT indicates that behaving consistently with values is associated with positive wellness outcomes including less psychological distress (Ciarrochi et al., 2010; McCracken & Yang, 2006), increased life satisfaction (Lundgren, Dahl & Hayes, 2008), and increased self-reports of quality of life (Michelson, Lee, Orsillo, & Roemer, 2011; Lundgren et al., 2008). A commitment to intrinsically motivated social values has also been linked to positive affect (Ferssizidis, Adams, Kashdan, Plummer, Mishra, & Ciarrochi, 2010). In contrast, when their behaviors are incongruent with their personal values, individuals experience more psychological distress (Plumb & Hayes, 2008; as cited in Plumb et al., 2009; Wilson et al., 2010). Despite limited research on specific values interventions, preliminary evidence on ACT indicates that values intervention components serve as mediators to well- being outcomes (Lundgren et al., 2008). However, the process of valuing is not well understood. In particular, how individuals clarify personal values and the mechanisms of values-behavior congruence, as well as the process through which values-congruent behavior influences SWB, require investigation. Research suggests that novice therapists are vulnera- ble to stress and burnout, which can affect both personal wellness and professional effectiveness (Skovholt & Jennings, 2004; Stafford-Brown & Pakenham, 2012). A non-randomized controlled trial of a group ACT inter- vention reduced stress in clinical psychology students in Australia (Stafford-Brown & Pakenham, 2012) and also enhanced positive therapist qualities such as self- compassion. Two out of the four sessions offered were devoted to values work (e.g., clarifying values, setting values-congruent goals). However, there are no stud- ies that have examined the process of developing values specifically. The current study investigates the process of values awareness development, values-behavior congruence, and the way that values-congruent behavior influences well-being in therapists-in-training. More specifically, the study investigated the following research questions about psychotherapist trainees: 1) Which processes facilitate values clarification? 2) Which processes hinder the values clarification process? 3) What processes are associated with values-congruent behavior? 4) Which processes hinder values-behavior congruence? 5) How does values work relate to SWB? A qualitative approach was utilized to allow for a rich and complex examina- tion of the valuing process, as research of this nature is limited and much needed to elucidate the processes involved in values clarification and enacting values- congruent behaviours, as well as the relationship between these processes and SWB. 20 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Method Participants Sixteen female (13 Caucasian, 1 South East Asian, 1 Jamaican, 1 Multiethnic) Master of Arts (MA) students in Counseling Psychology at a Canadian university, completing their first year of studies including a first practicum participated. Participant’s ages ranged from 22 to 46 years old (M = 28.38, SD = 6.18). Procedures The current study received approval from the university’s research ethics board (REB). Informed consent was obtained prior to the start of the study. Participants received a three-hour values clarifica- tion workshop (conducted by a doctoral student and professor in the Counseling Psychology program) that included teaching of the ACT approach to valuing, information about its efficacy, and experiential values clarification and committed action exercises. The values clarification exercises included: 1) A guided visualiza- tion where participants imagined their convocation ceremony and envisioned what their ideal life would look like in the interim 2) An independent writing exer- cise where participants listed things they wanted to stop, start, and continue doing 3) Discussion in dyads to iden- tify themes and meaning among the three lists that could help to highlight a value(s). Committed action exercises included: 1) working in dyads to set values-congruent goals to be achieved in: 24 hours, 1 week, and 1 month, and 2) making a commitment with a partner and devis- ing strategies to hold one another accountable to goals (e.g., check in emails). Participants were interviewed two weeks after the workshop and asked to discuss their experiences during and after the workshop, their process of values clarification and values-behavior congruence, and their sense of well-being, including mood, life satisfaction, pleasure, engagement, and meaning. The interview was semi-structured such that there was a list of open-ended questions referred to by all of the interviewers (in order to ensure that all topics of interest were covered, e.g., process of values clarification); however, the questions were not asked verbatim nor in a particular order. The interview was guided primarily by the salient topics to the participant. The interviews, which ranged from 20 to 45 minutes, were conducted by the first author and two doctoral students in Counseling Psychology and were transcribed for analysis. Data Analysis Consensual Qualitative Research (CQR; Hill, 2012; Hill et. al, 2005; Hill, Thompson, and Williams, 1997) was used to analyze the data. CQR is a qualitative method, which aims for an in-depth examination of individual experiences, as well as a cross-case analysis to identify themes that emerge across participants (Hill et al., 2005). It utilizes several coders in order to foster multiple perspectives throughout the process and to achieve consensus regarding the essence of the data (Hill et al., 2005). An auditor reviews the work of the primary coding team in order to minimize the possibility of groupthink (Hill et al., 2005). There are three steps in this process, including the identification of domains (topic areas), the construction of core ideas (essence of participant statements), and the cross-case analysis (discerning themes across participants). In the current study, the primary research team was made up of one MA student studying counseling psychology (Caucasian, female, 26 years old) and two female undergraduate volunteers studying psychology (21 years old, Caucasian, and 22 years old, African Canadian). The auditor was a 25-year-old, Caucasian, female MA student. Each team member analyzed the data independently and meet- ings of all team members were held to reach coding consensus. The primary team generated a baseline domain list of topic areas based on constructs of interest (e.g., mood, life satisfaction, values clarity) prior to beginning analysis (Hill, 2012). The three primary team members coded independently to domains, arrived at consensus, and refined the domain list to the final seven domains. The primary coders formulated core ideas of the partici- pant statements for the first three transcripts to ensure consistency and then individual coders constructed core ideas independently and the other two members reviewed them at a consensus meeting. In CQR, core ideas refer to brief phrases that abstract the essence of participant’s statements (e.g., participant feels the workshop provided her with tools to articulate her values, participant uses values as compass for decision making). The consensus version for each participant was audited (to ensure the data was accurately represented 21 ACT VALUE CLARIFICATION and placed in the appropriate domains) and the primary team integrated the auditor’s feedback. The primary team then examined the core ideas across cases and grouped core ideas into categories (e.g., positive mood change, enhanced life satisfaction, arrived at clear ACT value), which is the term for themes in CQR (Hill et al., 1997). Coders independently developed a category list for each domain and then synthesized their lists, following a consensus process. After an exter- nal audit of these lists, the primary team finalized the categories for each domain. The first author calculated if the categories were general (15–16) typical (>9), variant (4–8), or rare (2–3) as per CQR guidelines (Hill, 2012; Hill et al., 2005; Hill et al., 1997). Results The results are presented by research question and domain. The process of values clarification is eluci- dated and participant’s experiences of values-behavior congruence are discussed. Finally, the way that partici- pating in this process influenced participant’s SWB is elaborated. Typical and variant categories are presented; rare cases are only discussed if they inform the research question (see Table 1–3). Frequencies of categories are indicated in parentheses. Domain 1: Values Clarity The processes that lead to and hinder values clari- fication are presented first to provide context for other processes and supports. Outcomes. Participants reported that the values clarification process was helpful (typical), however the depth of the experiences ranged from glean- ing subtle insights to making profound discoveries. Participants also varied regarding the degree of clar- ity some described arriving at a clear ACT value that was characterized by a quality of action (variant). For example, one participant said: “I was sort of surprised to arrive at a core value . . . There was just one and it was actively authentic.” Similarly, another participant shared that behaving genuinely is deeply important to her and named this value “freely being.” Another partici- pant described her ACT value as “living appreciatively” and explained it is important for her to consciously engage in gratitude. A couple of participants reported furthering their understanding of a value but had diffi- culty articulating a clear value (rare). One participant described a process that: Really feels like a shadow or like a cloud. You can see it, but as soon as you get to touch it, it kind of disappears or it’s really hard to grasp. That’s what I feel like my values are like. I have the idea, I have the shape in my head, but I can’t really touch it or I can’t really put my finger on it. Participants often reported that they had previously engaged in a personal values clarification (typical); learning about ACT in courses had inspired them to reflect on their values prior to the workshop. Others reported being engaged in the process because of personal circumstances (e.g., being older,). Participants also expressed new learning about values from the workshop (typical). One participant said: I think the workshop helped in terms of just increasing my awareness about it. I think they’re things that I started to think about . . . learning about values and engaging in that continuous self-reflective process got me beginning to think about it and then this provided more of a streamlined framework for how to think about it instead of just brainstorming on my own. Process. Overall, participants described the values clarification process as one that is complex, difficult, and requires substantial reflection. For instance, participants found the values clarification process to be challenging at the cognitive level (variant): “It was difficult . . . it took a lot of focus, and thought, and reflection . . . it was like whoaaa! I felt like I needed to get reoriented.” There were also emotional elements in participant reactions to the process: I have that thought process where I’m like spinning out of control and . . . This is really resonating with me, and this is really salient. I know it’s important to me, like connecting with people, and I think that part gets overwhelming. Sometimes participants felt frightened: “I think talk- ing about values can be very scary, especially as we’re confused when we’re getting there.” One participant felt drained from the workshop by the process of being constantly engaged and genuine. In spite of its 22 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Table 1 Domains, Categories, Frequencies, and Illustrative Core Ideas for Values Clarification Outcomes and Process Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Values Clarity Outcome Workshop was somewhat helpful for advancing values clarity T (n = 12) Gained awareness of values that mattered and was helped to build upon this awareness. Arrived at clear ACT value V (n = 5) Discovered values gratitude in workshop and wants to live more appreciatively. Further clarity, did not get to core value R (n = 3) Was aware family domain was important and explored this in dyad, got to certain layers, but difficulty identifying core ACT value. Previous values awareness T (n = 11) Has thought about values before and feels identifying values is an ongoing process. Some new learning relative to values from workshop T (n = 9) Aware of some values before, workshop helped her clarify more. Minimal/no learning relative to values R (n = 2) Well-developed values clarity prior to participating. Process Inspired further reflection on values post workshop V (n = 6) Continued reflecting on identifying her value post-workshop but not enough processing time and it eventually “faded away.” Time as barrier to values clarification process, which is complex V (n = 6) Clarified value was about connection with others but was unable to fully flesh it out due to time constraints. Process was challenging and overwhelming V (n = 5) Process was difficult and required a lot of focus and reflection. Felt overwhelmed and needed to “reorient.” Helped articulate values R (n = 3) Workshop has given her tools to articulate her values. Highlighted values conflict/ hierarchy R (n = 3) Realized values social connection more than other things. Still wants to do well academically but feels like less of a perfectionist now. Supports to process Working in dyads/verbalizing about values facilitated values clarification V (n = 6) Aware of values related to wellness before workshop, was able to explore more by discussing it with partner. Values conceptualization changed to ACT V (n = 6) Workshop changed way thinks about values; found the adverb and quality of action element interesting and values made more sense to her after learning this. Workshop exercise “start, stop, keep doing” was helpful for values clarification V (n = 5) The “things I want to stop, start, keep doing” exercise was helpful; was able to see how these three things relate. a T = Typical, V = Variant, R = Rare. 23 ACT VALUE CLARIFICATION difficulties, it seemed worthwhile: a participant noted that she was “emotionally overwhelmed” during the session but also that it was “an amazing and enlighten- ing experience.” Participants explained that a lack of sufficient time was a barrier to achieving values clarity, in this complex process (variant). Several participants were only able to clarify the domain of their value and uncover some layers. One indicated that her value related to social connection, but explained: “The problem was that we didn’t have enough time in our dyad for me to really flesh mine out, which I think it’s why I’m in a weird head space about it.” Another reported being able to iden- tify her value was related to family and she “uncovered some layers” but was unable to articulate related actions. Another participant noted: “ . . . I would’ve been very surprised if I had [achieved clarity]. . . . I’m in therapy right now and I’m kind of thinking, if I get there it might be in a longer process.” Although they were not always successful in identifying core values, they indi- cated that the workshop inspired immediate reflection on values (variant) however some noted that they soon became distracted by other responsibilities. Supports to the process. Participants appreciated structured and concrete ways to think about values, and that these type of activities support the values clarifi- cation process. An activity enumerating the things “I want to start, stop, and keep doing” was nominated as helpful for values clarification (variant). One participant said that in looking at the things she wanted to stop doing she was able to realize that she had the tendency to be pessimistic and that considering values allowed her to recognize that she wants to be more apprecia- tive. Working with a partner was useful in achieving clarity (variant): “I was able to identify it and to kind of just talk about it. And I think the more you talk about it, the more it makes it concrete, and more attain- able.” Participants also described how understanding the relationship of values to action facilitated values clarification (variant). One participant noted: to think about how its embodied or experienced in your life when maybe you haven’t acted in accordance with that value or the times that you have . . . it made it more of a concrete thing than just an abstract term that we throw around. Domain 2: Values-Behavior Congruence Participants described both cognitive and behavioral processes leading to values-based actions and the barriers and supports to this endeavor. Cognitive processes. Participants began to engage in a number of cognitive processes in which the importance of the relationship between values and behavior became more salient. Half of the participants came to understand that congruence is beneficial or that incongruence is detrimental (variant). Some believed that acting congruently would make their lives “easier and less emotionally draining.” Others had already experienced positive outcomes of congruence for example reductions in stress and burnout. One participant explained that although her behavior was not congruent at the time, “I think that if I actually put my values into action, I would be less burned out.” Another participant believed that if she were to act congruently in the future: . . . then there will be that part of me that’s more fulfilled, which will be more nourishing and hopefully give me the space to really manage all the other things better, instead of feeling kind of constantly drained and in need of something that I’m not really getting. One participant described how when she acts incongru- ently, she feels a sense of guilt or dissonance but when she acts congruently she feels “ . . . whole, and more like herself.” Participants reported gaining recognition of values- behavior incongruence as a result of participating in the values clarification process (variant). More specifically, they reported becoming aware of the areas of their lives where their values and behaviors were incongruent. One participant said: “For me it really highlighted the voids in my life and the things I wanted to make more full and live more authentically.” Several of these participants also reported that the recognition of incongruence highlighted the need for behavioral change. For instance, one participant said: “I think for me was an eye opener because it was like yeah I really do need to start implementing these things in my life because there is not a balance.” Participants also indicated that their sense of mind- fulness was enhanced as a result of trying to enact values-congruent behaviors (variant). One participant 24 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Table 2 Domains, Categories, Frequencies, and Illustrative Core Ideas for Values Behavior Congruence Outcomes and Process Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Values Behavior Congruence Cognitive Insight congruence is beneficial and incongruence is detrimental V (n = 8) Expresses insight that living in congruence with values makes life easier and less emotionally draining. Recognition of incongruence V (n = 6) Areas of incongruence were bought to awareness and helped her realize desire to begin implementing values congruent behaviors. Increase in mindfulness V (n = 5) More self-aware and has made conscious efforts to choose values-congruent behaviors when she becomes aware of a challenging choice in the moment. Use of values in decision making V (n = 5) Uses values as a compass, which guides her decision making. Motivation for behavioral change V (n = 4) Workshop gave motivational push towards achieving her goals. Behavioral Effort/steps toward congruence T (n = 10) In process of trying out different behaviors to see which make her feel better. Trying to implement more quality time with friends and see how that makes her feel. Discussed successful efforts in congruence V (n = 8) Feels successful in implementing values related to spending time with friends. Difficulty implementation congruent behavior despite efforts/steps taken R (n = 2) After workshop, has been taking steps to ensure she can adhere to her goal (e.g., setting up yoga things beforehand) but she is still struggling to adhere to her health rituals. Engaged in values congruent behavior prior to workshop V (n = 5) Had been making a conscious effort to behave according to values for several years. Was exposed to ACT valuing in the academic context too. Barriers Work demands T (n = 11) Often behaves incongruently with values because in prioritizing school, her values are put on hold. Lack of energy R (n = 3) Set goals after the workshop but did not achieve them or make an effort to, attributes this to burnout. Feels burnout is a barrier because when she feels burned out she does not want to do anything, which then contributes to further burnout in a “vicious cycle”. Desire to look good/please others R (n = 2) There are times where she has acted in a manner incongruent with her values due to a desire to please others. 25 ACT VALUE CLARIFICATION explained: “I’ve been really trying to be more mindful when I do activities . . . trying to be more in the room . . . more present in the moment.” Another described making an effort to stay present in leisure activities, despite her tendency to become consumed by her responsibilities: when I catch myself thinking, okay what do I have to do later I try to snap myself out of it and just go back to that moment and not think about all the other stuff. Because it’s going to be there regardless of whether you think about it or not . . . I think the workshop helped me do that . . . just being more aware. Another participant indicated that she is more conscious of moments where her behavior and values are incon- gruent leading her to question the purpose of her behavior and try to reframe her thinking. Participants also described motivation for behav- ioral change as a result of the values clarification process (variant). Regarding self-care, one participant stated: I sit there and think about it all the time, but I don’t actually do anything about it and I think the workshop really made it real for me . . . I should be starting to implement some things. And it’s funny because since the workshop I actually have. Another described how she has struggled to implement values-congruent behaviors and continues to think about this: “Even though I haven’t done it, I’m still trying in my head to make more realistic goals.” Several participants also described using their values as a guide to making decisions (variant). One participant described values as a “guiding framework” to making big decisions. Behavioral processes. Participants reported taking some steps—big or small—to implement values- congruent behaviors (typical). Half of participants described successful efforts (variant), such as complet- ing goals set in the workshop. Others discussed more general steps such as intentions, or plans devised with a therapist or spending more quality time with friends. Participants often reported having been intentionally engaged in values-congruent behavior before the work- shop (typical). Some of these individuals experienced less impact from participating in the workshop. Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Conflicting values R (n = 2) Does not know how to live “everyday values”, as feels that bigger values conflict with “everyday values. Supports Dyads helped congruence V (n = 8) Checking in with partner was helpful. Was thinking of not doing what she said she would but then realized she would have to tell her partner she did not do it. Feelings of accountability V (n = 7) Saying her goal out loud to her dyad partner gave her a sense of accountability. Help with ideas for implementation R (n = 2) Talking with her partner helped her to come up with a successful solution to implement one of her goals. Writing/verbalizing ideas about values related behaviors R (n = 3) Writing down the things she wants to do/not do is helpful, as she feels more responsible for acting on it. Breaking goals down in to smaller steps/shorter time frames R (n = 3) Felt the short-time frame helped her achieve goal; long-term goals can be scary to implement due to the commitment required. a T = Typical, V = Variant, R = Rare. 26 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Barriers to congruent behavior. Participants often reported barriers in one typical and three rare categories. Participants indicated that work demands were barriers (typical). Two participants explained that schoolwork and the pressure to be perfect served as barriers to values-congruent behaviour. Two partici- pants explained that although they are in school for a values-related purpose, it interferes with their ability to engage in congruent behaviours: “I feel like I know there is a purpose here and I love being in school . . . But it also does take a lot away from other areas in your life.” Although work demands emerged as the most common barrier to values-behaviour congruence, some rare categories warrant discussion. Values conflict was nominated as a barrier to congruence (rare). For exam- ple, one participant explained how her value of self-care and caring for others can sometimes create a conflict. Some participants also discussed that a lack of energy or feeling burned out served as a barrier to living out their values (rare). Finally, the desire to look good or please others was mentioned as a barrier to values-congruent behaving (rare): I realized lately that I really tend to adapt to others and I feel like I kind of lose myself sometimes too, like by trying to please others and trying to be kind of a superwoman . . . I find I don’t really stand my ground. Supports for congruent behavior. Participants also discussed how exercises that involved articulating intended values congruent actions, and breaking actions in to manageable segments facilitated values-congruent behavior. The particular supports discussed emerged as several variant and several rare categories. Participants highlighted how having a partner gave participants a sense of accountability to the goals they set and supported values-congruent behaviors (vari- ant). Occasionally a partner helped another to generate ideas for values-congruent action (rare). Verbalizing or writing about values made things seem more concrete and helped move some toward action or increased their commitment (rare): “I kind of feel more responsible for acting on it, now that I wrote it down . . . ” Lastly, participants explained that breaking their goals down in to smaller steps and shorter time frames was helpful (rare). For example, one participant attributed success in achieving a goal to the short-term time frame; long-term goals were scary because of the commitment required. Values and Subjective Well-Being (SWB) Domain 3: Mood Participants often reported a positive mood change following the workshop (typical), however, there was variability regarding the attributions for positive changes. Some nominated value-behavior congruence as respon- sible for the change (variant): “I think it’s more the actions that I took according to the things that I real- ized in the workshop.” One participant explained that exercising was a behavior related to her value of “freely being” and had a positive impact on her mood: “It’s been consistent in terms of the time that I put toward it, and it’s a huge influence on my mood . . . I just feel like the energy and the positivity was just coming from that.” Another participant described values clarifica- tion as a catalyst: “The workshop had an impact . . . my other courses had an impact, my relationship with my boyfriend had an impact . . . I think the workshop and this process have kind of got the ball rolling for me.” Domain 4: Life Satisfaction Participants saw values-behavior congruence as increasing life satisfaction or incongruence as decreas- ing it (variant): I think it is enhancing it for sure . . . one of my values is family and sometimes when I am torn between homework or spending time with my kids for example, it helps me make that decision and I’ll spend time with my kids and in the end I am happy I did . . . the fact that I am using my values as a sort of compass enhances my life and my decision making. Another participant explained that being in the Counseling Psychology program enhances her life satis- faction because it is congruent with her values. Several individuals reported an enhanced sense of life satisfac- tion following the workshop (variant). Two of these individuals explained that life satisfaction was enhanced due to an increased effort towards values-congruent 27 ACT VALUE CLARIFICATION behavior following the workshop. One of these partici- pants stated: I’m more satisfied with my life right now . . . I’ve been really focusing on my relationship with my partner and we’ve been having an amazing two weeks . . . we’ve been really reconnecting, . . . just talking about it made me realize my values were a little off and that I want to be more present. Several rare categories in the life satisfaction domain warrant mention. Participants discussed a relationship between gratitude, valuing, and life satisfaction (rare). For instance, one participant explained that the values clarification process had increased her sense of grati- tude and enhanced her life satisfaction: . . . School can be miserable, but I’m here for a reason. I have made that choice, I think learning how to reframe the things in my life that are sometimes a bit negative, trying to see the silver lining or be more grateful for the things I do have has kind of helped with my life satisfaction. Additionally, three of the participants explained that they were satisfied with their life on a broad scale, despite daily stressors that diminished immediate satisfactions (rare): I know I want to be in school. I wanted to come to this program . . . so that’s good, I got in, I’m here. But . . . it takes away from all those little things that would probably make my everyday life a lot more satisfying. . . . So the workshop was kind of thinking about the things I can do while I’m in school to make things more enjoyable. Domain 5: Pleasure The only categories within the pleasure domain were rare (see Table 3). Domain 6: Engagement Participants reported seeing a relationship between flow and living out values (variant): “When I’m in those flow moments I’m not really, thinking of my values. But I guess what I’m doing gives me satisfaction because it fulfills my values.” Another participant talked about the relationship between engaging and pleasurable activities: “It was helpful to think about the things that give me immediate gratification and made it less likely for me to do them . . . engaging activities are more in line with values than pleasurable activities.” Another participant explained that she identifies one of her values as “living passionately or taking the time to live.” When she is in the moment, she feels that she is nourishing this value like times when she and her children draw together. Domain 7: Meaning Half of the participants endorsed the idea that living out values contributes to a sense of meaning (variant): “an inherent part of valuing is the meaning it gives.” The fact of being in a Counseling Psychology program was one expression of values, for example contributing to the lives of others brings meaning by enacting a value related to kindness. Discussion The Valuing Process Although the participants of the study typically experienced new learning about values, the results underline the idea that values clarification is a complex process, involving both cognitive and emotional chal- lenges. The complexity of the values clarification process (Rogers, 1964; Stewart, 1975) and the abstract nature of the construct (Hitlin & Piliavin, 2004; Maio, 2010; Eyal, Sagristano, Trope, Liberman, & Chaiken, 2009), have been well documented. These participants reported that exercises such as listing things they wanted to stop, start, and continue doing were helpful because they made the concept more concrete and tangible. Discussing values aloud with a partner also helped to structure the process and address the difficulties of working with an abstract and vague construct. These findings are in line with Levitt and colleagues (2006) who found that clients found structured interventions in individual therapy productive for developing insights; unstruc- tured interventions allowed them to avoid emotional topics. Similarly, research from group psychotherapy suggests that structured exercises can enhance engage- ment, communication, and problem solving and lack of structure can contribute to anxiety and hinder prog- ress (Johnson, 2009). Given the emotional challenges of the values clarification process, the help provided by structuring may have reduced the ambiguity of the task and the anxiety associated with it. Lessening the 28 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Table 3 Domains, Categories, Frequencies, and Illustrative Core Ideas for Subjective Well-Being (SWB) Outcome and Process Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Mood Positive mood change T (n = 9) Workshop had an impact on her mood through realizations that influenced her actions after the workshop. Attributed to values- behavior congruence V (n = 6) Feeling better since workshop and attributes the difference in mood to changing her behavior to be more congruent with her values. Attributed to other factors R (n = 3) Attributes positive mood to weather and academic session in the summer being less heavy. Negative mood change R (n = 2) Mood was initially lowered, as a result of discovering incongruence between her values and behavior. Does not feel it had an impact on her mood in the long term because the incongruence realization inspired her to think of ways to change her behavior. For unspecified reasons, participant 2 reports feeling more burnt-out, fatigued, a more negative mood and decreased concentration but does not feel that this is related to the workshop. Emotional experience during/immediately after the workshop R (n = 3) Felt very emotional, as a result of discovering incongruence during the workshop. Life Satisfaction Expressed insight values- behavior congruence increases life satisfaction/ incongruence decreases life satisfaction V (n = 6) Feels that when she lives out her values in the future she will have more life satisfaction. Enhanced life satisfaction since workshop V (n = 4) Since the workshop, her life satisfaction is “moderately higher,” although it is hard to quantify. She states that she has more stability across domains, as she is making a conscious effort not to let school override everything else in her life. She is trying to create more balance by working out and spending more time with family and friends. Described relationship between life satisfaction, gratitude, and valuing R (n = 3) Life satisfaction hasn’t changed dramatically since workshop. However, her increased sense of gratitude (e.g., appreciating her choice to be in graduate school even when things are difficult) since the workshop has helped with her life satisfaction. 29 ACT VALUE CLARIFICATION Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Valuing helps create balance in life R (n = 3) Made effort to “challenge” her current balance, as well as create more balance in life since workshop. Broad life satisfaction despite daily stressors R (n = 3) Expresses insight that when looking at her life broadly she is satisfied, as she is pursuing an educational path congruent with her values, but is not satisfied with her everyday life. Being in school interferes with her ability to do other things she values (e.g. working out, volunteering) but she would not change that because she is satisfied with her overall direction. Pleasure No change in way thinks about or engages in pleasurable activities since workshop R (n = 3) Pleasure seeking behaviors, or the way that she thinks about them have not changed much since workshop. Increased frequency of pleasurable activities since workshop R (n = 3) Does not think workshop changed the way she thinks about pleasure seeking activities consciously, but notices that she has been trying to create a better balance in her life and increasing the amount of hedonistic activities (e.g., TV, partying). Less rigid/feels less guilty about doing pleasurable things since workshop R (n = 2) Feels that workshop influenced her pleasure- seeking behaviors in that she is less rigid and is taking time to do things she enjoys. Pleasurable activities require less effort than meaningful ones and done more often R (n = 2) Feels that hedonistic activities require less planning and effort than meaningful activities; she engages in them because they are less daunting than other things and she knows they feel good. Engagement Sees relationship between flow and living out values V (n = 6) Feels that engaging activities are more in line with values than pleasurable activities. No change in way thinks of/experiences flow sine workshop V (n = 6) Does not feel that the way she thinks about or experiences flow has changed since the workshop. Rarely/never experience flow V (n = 5) Does not feel workshop had impact on engagement; does not recall flow moments since childhood. Therefore does not see connection between values and flow R (n = 3) Does not experience flow in her everyday life; therefore does not see a connection between valuing and engagement. Meaning Living out values contributes to a sense of meaning V (n = 8) Notes that for her, values and meaning go together; if she acts based on her values it adds meaning to her life. 30 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL overwhelming nature of a complex task can help to sustain engagement in the process. When considering the process of translating values to action, the results of the current study indicate that both cognitive and behavioral processes are involved. This is consistent with the values literature, which suggests that values need to be cognitively activated in order to be enacted and to influence information processing and behavior (Higgins, 1996; Kruglanski, 1996; as cited in Verplanken & Holland, 2002; Maio, 2010). In the current study, participants reported that through the process of trying to implement their values, they became more conscious of their behavior and were better able to recognize incongruence. This provides support for the idea that values must be activated. Through this process, participants reported an enhanced sense of mindfulness, or present moment focus, which might be an example of this cognitive activation process. This particular finding is interesting because although mindfulness was not explicitly taught in the workshop, it is a fundamental component in the ACT model (Hayes et al., 2006). Research indicates that automatic processing tends to limit our ability to consciously choose values-congruent behaviors from moment to moment, however mindfulness can help us to intention- ally choose values-congruent actions (Brown & Ryan, 2003; Shapiro, Carlson, Astin, & Freedman, 2006). In other words, mindfulness supports values-congruent behavior. The findings suggest, however, that values- congruent behavior can support the development of mindfulness. Perhaps a bidirectional relationship exists such that values-behavior congruence enhances mind- fulness, due to the cognitive activation required in this process, and in turn mindfulness further supports the activation of values-congruent behaviors. Despite indicating that values-behavior congruence was desirable, participants typically reported barriers to behavioral implementation. Frequently reported barriers were work demands and the time for values work. These findings echo the self-care research, in which time is the most frequent barrier to psychology graduate students’ practice of wellness activities (El-Ghoroury, Galper, Sawaqdeh, & Bufka, 2012) or between workshop exer- cises (Pakenham & Stafford-Brown, 2013). As values are intended to be expressed in moment-to-moment behav- ior (Hayes, Pistorello, & Levin, 2012), trainees require more help to connect this process to their current day- to-day life. Also of note, it was typical of participants in the current study to report being previously engaged in a form of valuing prior to participating in the workshop. This included reflection to clarify values, as well as an effort to implement values-congruent behaviors. Many of these participants shared that this process began upon being exposed to ACT theory. The findings indicate that teaching ACT to trainees in an academic Domains/Subdomains Categories/Subcategories Frequencya Core Ideas Workshop helped to envision what they want/would bring meaning in the future R (n = 2) Workshop helped her think of what matters in a broadened way, and consider her future and “the grand scheme of things.” Currently not engaging in much meaningful activities but have ideas about sources for meaning in future (related to values) R (n = 2) The workshop impacted the way she wants her future life to be. Feels it is difficult to achieve a sense of meaning while in school and sees herself developing this sense more in the future. Sees her sense of meaning being related to her values in the future. Sources Social connection V (n = 6) Workshop really resonated with her and made her aware that meaning and purpose comes from living out her value of social connection. Helping others R (n = 3) Derives meaning from becoming a counselor and feels that through helping others in her work she can live out her values. a T = Typical, V = Variant, R = Rare. 31 ACT VALUE CLARIFICATION context might instigate a personal values clarification process. This experiential process might be beneficial both on an individual and professional level. Values and Subjective Well-Being Values clarification and values-behavior congruence was related to eudaimonic (meaning and growth-based) but not hedonic pursuits (pleasure-based) for partici- pants; half endorsed the idea that living out values contributes to a sense of meaning in life. Kashdan and McKnight (2013) found that having purpose in life was positively associated with meaning in life and positive emotions. Though purpose in life is not synonymous with values, the authors indicate that the constructs are very closely related (Kashdan & McKnight, 2013). Living according to values may enhance a sense of meaning and this may be the mechanism through which valuing enhances SWB. ACT posits that living a values driven life can produce a sense of meaning and purpose (Plumb et al., 2009) and the findings support this idea, however further investigation is needed to support the causal relationship between values and meaning. In the current study, participants typically reported positive changes in mood that they attributed, partially or completely, to increased efforts toward values-behav- ioral congruence. This relationship is consistent with the ACT literature; for instance, behavioral commit- ment to intrinsically motivated social values has been associated with positive affect (Ferssizidis et al., 2010) and a perceived incongruence between behavior and personal values has been linked to negative mood states, such as dejection (Maio, 2010), agitation (Maio, 2010), anxiety and depression (Nordin, Wasteson, Hoffman, Glimelius, & Sjoden, 2001). Only a few (N = 4) partici- pants reported enhanced life satisfaction. These findings are similar to Ly and colleagues (2012) who assessed the impact of a mobile ACT intervention on life satisfaction among non-clinical participants after four weeks and found no significant changes. Life satisfaction is a more stable construct than mood (Kashdan & Nezlek, 2012; Nezlek, 2005; Laurenceau, Troy & Carver, 2005) so that the effect of a single intervention was insufficient to create a level of change to affect life satisfaction. Several participants indicated that although their life satisfaction did not change, they understood how values-congruent behavior congruence could ultimately enhance it. The few participants who experienced enhanced life satisfaction attributed it to either increased efforts in values-behavior congruence or an increase in gratitude due to the values clarification process. Research suggests that gratitude has a robust, positive relationship with life satisfaction (Emmons & McCullough, 2003; Park, Peterson, & Seligman, 2004; Wood, Joseph, & Maltby, 2008). This area requires further investigation. Limitations Several limitations to the current study warrant discussion. First, two weeks is a brief period for impor- tant change. More extended follow-up over time is needed. Secondly, given that this was a pilot intervention study, the values intervention has not yet been empiri- cally validated (e.g., by using a randomized controlled trial design). In addition, although the CQR method utilizes multiple coders and an external auditor to mini- mize researcher bias, the first author is a Counseling Psychology graduate student and may have biases regarding the experience of valuing and wellness in trainees. It is also important to acknowledge that some of the researchers (including students and a professor in the department) and participants had previous interac- tions being in the Counseling Psychology program. This might have created a sense of demand for a particular experience in the study for some participants. Finally, it is important to note that the sample was self-selected; therefore, participants may share important characteris- tics that are not well understood. Previous engagement in values clarification might therefore be an artifact of our study, either because participants had previous exposure to ACT in the Counseling program or because they are innately reflective. Future studies should aim to examine whether the experience of participating in this process is different for individuals without previous exposure to ACT. Implications and Future Directions Overall, the findings suggest that values clarification is a complex and challenging process, which requires much time and reflection. It might then be worthwhile to extend the workshop and offer it over a series of several sessions, as this format has been found to be effective for similar types of interventions (Stafford- Brown & Pakenham, 2012; Shapiro, Brown, & Biegel, 2007). The findings suggest that it is essential to teach 32 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL individuals to express their values in their moment to moment behavior, even if in small ways. Given the diffi- culties involved in activating values-congruent behavior, values interventions could benefit from a greater empha- sis on addressing barriers to valued living. With regards to SWB, the findings indicate that values congruent living might contribute to a sense of meaning, which might in turn enhance SWB. Quantitative research is needed to examine causal mechanisms involved in the relationship between values-congruent behavior and SWB. ACT valuing interventions appear to be a prom- ising avenue through which to foster well-being and growth in novice therapists. Such interventions might be useful in supervision contexts to enhance well-being and potentially protect against the development of stress, burnout, and other forms of psychological distress and to give trainees an experiential basis for using this powerful work in their sessions. References Bolier, L., Haverman, M., Westerhof, G., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BioMed Central Public Health, 13, 1–20. doi:10.1186/1471-2458-13-119 Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. doi:10.1037/0022-3514.84.4.822 Ciarrochi, J., Fisher, D., & Lane, L. (2010). The link between value motives, value success, and well-being among people diagnosed with cancer. Psycho-Oncology, 20(11), 1184–1192. doi:10.1002/pon.1832 Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper and Row. Diene r , E . ( 2000 ) . Sub j ec t ive we l l - being. American Psychologist , 55 , 34–43. doi:10.1037//0003-066X.55.1.4 Diener, E., & Chan, M. (2011). Happy people live longer: Subjective well-being contributes to health and longevity. Applied Psychology: Health and Well Being, 3(1), 1–43. doi:10.1111/j.1758-0854.2010.01045.x Duckworth, A.L., Steen, T.A., & Seligman, M. E. P. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, 1, 629–651. doi:10.1146/annurev.clinpsy.1.102803.144154 El-Ghoroury, N. H., Galper, D. I., Sawaqdeh, A., & Bufka, L. F. (2012). Stress, coping, and barriers to wellness among psychology graduate students. Training and Education in Professional Psychology, 6(2), 122–134. doi:10.1037/a0028768 Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389. doi:10.1037/0022-3514.84.2.377 Eyal, T., Sagristano, M. D., Trope, Y., Liberman, N., & Chaiken, S. (2009). When values matter: Expressing values in behavioral intentions for the near vs. distant future. Journal of Experimental Social Psychology, 45(1), 35–43. doi:10.1016/j.jesp.2008.07.023 Ferssizidis, P., Adams, L. M., Kashdan, T. B., Plummer, C., Mishra, A., & Ciarrochi, J. (2010). Motivation for and commitment to social values: The roles of age and gender. Motivation and Emotion, 34(4), 354–362. doi:10.1007/s11031-010-9187-4 Frankl, V.E. (1997). Man’s search for ultimate meaning. New York. Plenum Press. Giannopoulos, V., & Vella-Brodrick, D. (2011). Effects of positive interventions and orientations to happiness on subjective well-being. Journal of Positive Psychology, 6(2), 95–105. doi:10.1080/17439760.2 010.545428 Hanson, W. E., Creswell, J. W., Clark, V. L. P., Petska, K. S., & Creswell, J. D. (2005). Mixed methods research designs in counseling psychology. Journal of counseling psychology, 52(2), 224. doi:10.1037/0022-0167.52.2.224 Hayes, S.C, Luoma , J.B, Bond, F.W, Masuda, A., & Lillis J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behavior Research and Therapy, 44, 1–25. doi:10.1016/j.brat.2005.06.006 Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976–1002. doi:10.1177/0011000012460836 Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: The Guilford Press. Hill, C. E. (Ed.). (2012). Consensual qualitative research: A practical resource for investigating social science phenomena. 33 ACT VALUE CLARIFICATION Washington, DC: American Psychological Association. Hill, C. E., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A., & Ladany, N. (2005). Consensual qualitative research: An update. Journal of Counseling Psychology, 52, 196–205. Hill, C. E., Thompson, B. J., & Williams, E. N. (1997). A guide to conducting consensual qualitative research. The counseling psychologist, 25(4), 517–572. doi:10.1177/0011000097254001 Hitlin, S., & Piliavin, J. A. (2004). Values: Reviving a dormant concept. Annual Review of Sociology, 30, 359–393. doi:10.1146/annurev. soc.30.012703.110640 Johnson, C. V. (2009). A process-oriented group model for university students: A semi-structured approach. International Journal of Group Psychotherapy, 59(4), 511–528. Retrieved from http://guilfordjournals. com/doi/abs/10.1521/ijgp.2009.59.4.511 Joseph, S., & Wood, A. (2010). Assessment of positive functioning in clinical psychology: Theoretical and practical issues. Clinical Psychology Review, 30(7), 830–838. doi:10.1016/j.cpr.2010.01.002 Kashdan, T., & Nezlek, J. (2012). Whether, when, and how is spirituality related to well-being? moving beyond single occasion questionnaires to understanding daily process. Personality and Social Psychology Bulletin, 38(11), 1523–1535. doi:10.1177/0146167212454549 Kashdan, T., & McKnight, P. (2013). Commitment to a purpose in life: An antidote to the suffering by individuals with social anxiety disorder. Emotion, 13(6), 1150–1159. doi:10.1037/a0033278 Keyes, C., Dhingra, S., & Simoes, E. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100(12), 2366–2371. doi:10.2105/ AJPH.2010.192245 Laurenceau, J., Troy, A., & Carver, C. (2005). Two distinct emotional experiences in romantic relationships: Effects of perceptions regarding approach of intimacy and avoidance of conflict. Personality and Social Psychology Bulletin, 31(8), 1123– 1133. doi:10.1177/0146167205274447 Levitt, H., Butler, M., & Hill, T. (2006). What clients find helpful in psychotherapy: Developing principles for facilitating moment-to-moment change. Journal of Counseling Psychology, 53(3), 314–324. doi:10.1037/0022-0167.53.3.314 Lundgren, T., Dahl, J., & Hayes, S. (2008). Evaluation of mediators of change in the treatment of epilepsy with acceptance and commitment therapy. Journal of Behavior Medicine, 31, 225–235. doi:10.1007/ s10865-008-9151-x Ly, H., Dahl, J., Carlbring, P., Andersson, G. (2012). Development and initial evaluation of a smartphone application based on acceptance and commitment therapy. SpringerPlus, 1, 1–11. doi:10.1186/2193-1801-1-11 Lyubomirsky, S., Sheldon, K., & Schkade, D. (2005). Pursuing happiness: The architecture of sustainable change. Review of General Psychology, 9(2), 111–131. doi:10.1037/1089-2680.9.2.111 Maio, G. R. (2010). Mental representations of social values. Advances in Experimental Social Psychology, 42, 1–43. McCracken, L., & Yang, S.Y. (2006). The role of contextual and cognitive-behavioral approach to pain. Pain, 123, 137–145. doi:10.1016/j. pain.2006.02.021 Michelson, S.E., Lee, J.K., Orsillo, S.M., & Roemer, L. (2011). The role of values-consistent behavior in generalized anxiety disorder. Depression and Anxiety, 28, 358–366. doi:10.1002/da.20793 Nezlek, J. (2005). Distinguishing affective and non-affective reactions to daily events. Journal of Personality , 73(6), 1542–1568. doi:10.1111/j.1467-6494.2005.00358.x Nordin, K., Wasteson, E., Hoffman, K., Glimelius, B., & Sjödén, P. O. (2001). Discrepancies between attainment and importance of life values and anxiety and depression in gastrointestinal cancer patients and their spouses. Psycho-Oncology, 10(6), 479–489. doi:10.1002/pon.536 Pakenham, K. I., & Stafford-Brown, J. (2013). Postgraduate clinical psychology students’ perceptions of an Acceptance and Commitment Therapy stress management intervention and clinical training. Clinical Psychologist, 17(2), 56–66. doi:10.1111/j.1742-9552.2012.00050.x Park, N., Peterson, C., & Seligman, M. E. (2004). Strengths of character and well-being. Journal of Social and Clinical Psychology, 23(5), 603–619. 34 GRUMET, FITZPATRICK, YILDIRIM, ANANNG, KNOLL Retrieved from http://guilfordjournals.com/doi/ abs/10.1521/jscp.23.5.603.50748 Plumb, J. C., Stewart, I., Dahl, J., & Lundgren, T. (2009). In search of meaning: Values in modern clinical behavior analysis. The Behavior Analyst, 32, 85–103. Retrieved from http://www.abainternational.org/ journals/the-behavior-analyst.aspx Rogers, C. R. (1964). Toward a modern approach to values: The valuing process in the mature person. The Journal of Abnormal and Social Psychology, 68(2), 160–167. Retrieved from http://psycnet.apa.org/ journals/abn/68/2/160/ Ryan, R.M., & Deci, E.L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141–166. doi:10.1146/annurev. psych.52.1.141 Schueller, S.M., & Seligman, M.E.P. (2010). Pursuit of pleasure, engagement, and meaning: Relationships to subjective and objective measures of well- being, The Journal of Positive Psychology: Dedicated to furthering research and promoting good practice, 5, 253–263. doi:10.1080/17439761003794130 Seligman, M.E.P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5–14. doi:10.1037//0003-066X.55.1.5 Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105–215. doi:10.1037/1931-3918.1.2.105 Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386. doi:10.1002/ jclp.20237 Sheldon, K., & Lyubomirsky, S. (2007). Is it possible to become happier? (and if so, how?). Social and Personality Psychology Compass, 1(1), 129–145. doi:10.1111/j.1751-9004.2007.00002.x Skovholt,T. M., & Jennings, L. (Eds.). (2004). Master therapists: Exploring expertise in therapy and counseling. Boston: Allyn & Bacon. Stewart, J. S. (1975). Clarifying values clarification: A critique. Phi Delta Kappa, 56(10), 684–688. Retrieved from http://www.jstor.org/stable/20298087 Stafford-Brown, J., & Pakenham, K. (2012). The effectiveness of an ACT informed intervention for managing stress and improving therapist qualities in clinical psychology trainees. Journal of Clinical Psychology, 68(6), 00. doi:10.1002/jclp.21844 Tay, L., & Kuykendall, L. (2013). Promoting happiness: The malleability of individual and societal subjective wellbeing. International Journal of Psychology, 48(3), 159–176. doi:10.1080/00207594.2013.779379 Vella-Brodrick, D.A., Park, N., & Peterson, C. (2009). Three ways to be happy: Pleasure, engagement, and meaning—findings from Australian and US samples. Social Indicators Research, 90, 165–179. doi:10.1007/ s11205-008-9251-6 Verplanken, B., & Holland, R. W. (2002). Motivated decision making: effects of activation and self- centrality of values on choices and behavior. Journal of Personality and Social Psychology, 82(3), 434–447. doi:10.1037//0022-3514.82.3.434 A. M., Joseph, S., & Maltby, J. (2008). Gratitude uniquely predicts satisfaction with life: Incremental validity above the domains and facets of the five factor model. Personality and Individual Differences, 45(1), 49–54. doi:10.1016/j.paid.2008.02.019 Wilson, K., Sandoz, E., Kitchens, J., & Roberts, M. (2010). The valued living questionnaire: defining and measuring valued action within a behavioral framework. Psychological Record, 60(2), 249–272. Retrieved from http://thepsychologicalrecord.siu. edu/