Book Review: The ACT Workbook for Depression & Shame

The ACT Workbook for Depression & Shame is written by psychologists Matthew W. McKay, Michael Jason Greenberg, and Patrick J. Fanning. It’s based on acceptance and commitment therapy and focused on addressing the defectiveness schema in depression.

The book begins and ends with a series of several self-assessment questionnaires to let you see how much progress you’ve made while working through the book.

The book includes quite a few worksheets. These are simply laid out, and clear examples are provided. The example scenarios included in the text were relatively lengthy; I would have preferred it if they were a bit shorter.

A key concept mentioned throughout the book was defensive coping behaviours (DCBs). These behaviours served a purpose at the time, but continue even after they’re no longer helpful. The book notes that they often fall within the categories of overcompensation, surrender, and avoidance. It explains that “When you follow the urge to engage in the DCB, you reduce your pain in the moment, but this ensures that your defectiveness remains unchallenged.”

One of the strategies the authors suggest is “creative hopelessness,” which means recognizing that what you’re doing isn’t working, so it’s time to come up with something new.

There’s a chapter on mindfulness that ties into defense coping behaviours, including work on identifying the moments when you choose to use a defensive coping behaviour. There’s also a chapter on values, and defensive coping behaviours are framed as taking you away from your values. Other topics covered included cognitive defusion, avoidance, self-compassion, and relapse planning.

I felt an immediate sense of pushback to this bit:

You became depressed because your life evolved into being about avoiding shame and defectiveness feelings. You became less and less the person you wanted to be as you engaged in more avoidance and more DCBs. There is the basic choice in life: doing what matters, doing what you care about, or having your days focused on trying to escape pain.

I could rant, but I’ll skip that. Other than that, though, there wasn’t anything else that was cringe-inducing for me.

Given that I’m a fan of ACT, and I was really impressed by Matthew McKay’s other book, the Dialectical Behavior Therapy Skills Workbook, I had high expectations for this book. In the end, for me, it didn’t live up to those expectations. The book isn’t terrible by any means; it just wasn’t a standout for me.

The ACT Workbook for Depression & Shame is available on Amazon (affiliate link).

I received a reviewer copy of this book from the publisher via NetGalley.

You can find my other reviews on the MH@H book review index or on Goodreads.

The post Acceptance and Commitment Therapy Metaphors is where you can find all things ACT-related on MH@H.