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Values Clarification: How Reflection On Core Values Is Used In CBT

Values Clarification: How Reflection On Core Values Is Used In CBT

Values Clarification is a technique used in cognitive-behavioral therapy (CBT) that aims to help people understand their value systems.

This article will cover what values clarification is and why it’s important in CBT. Finally, this article will cover how to use values clarification in therapy.

This article contains:

  • What Is Values Clarification? A Definition
  • Why This Technique Is Important For CBT
  • 15+ Examples Of Personal & Core Values
  • The Influence Of Moral Dilemmas On A Value System
  • Values Clarification Approach In Therapy: 10 Exercises
  • 3 Values Clarification Worksheets & Activities
  • A Take Home Message
  • References
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What Is Values Clarification? A Definition

Values are “fundamental attitudes guiding our mental processes and behavior” that “produce the belief that life is meaningful and serve as a measure of how meaningful one’s actions are, that is, consistent with that person’s value system” (Vyskocilova et al., 2015).

Values clarification is an aspect of CBT that involves identifying a patient’s personal value system and creating a hierarchy of values that are important to that patient.

This value system is used to set treatment goals for the patient and can help a patient exit their comfort zone in order to improve their quality of life.

 

Why This Technique Is Important For CBT

Clarifying patient values is important for mental health services. Surveys of people who use mental health services in England have found that a common complaint is that “care was ‘done to’ them rather than shaped with them”, and that people “wanted to be listened to, to have their experiences validated, to be seen as a person and not just a set of symptoms, and to be given hope” (Brabban et al., 2017).

Values clarification is particularly important in CBT because some people might view CBT as a “technical psychological intervention that prioritises techniques or strategies over relationships and values”.

Values clarification is also important in CBT (and other therapeutic interventions) as an assessment tool. That is, patients undergoing CBT can list their treatment goals at the beginning of treatment, then assess how the intervention went based on those goals (Heapy et al., 2018). This offers a somewhat-objective rating of how successful treatment was.

In Acceptance and Commitment Therapy (ACT), a form of CBT, the goal is “to improve functioning by increasing psychological flexibility, defined as the ability to act effectively in accordance with personal values in the presence of negative private experiences such as pain or distress” (Wicksell et al, 2007).

People undergoing CBT who are aware of what their values are can use those values as a way to withstand some discomfort, such as overcoming shyness to fulfill one’s valuing of a social life, for example. This is particularly helpful for exposure therapies, when someone needs to face an immediate discomfort for long-term wellness.

Since value systems can be “partly or wholly unconscious” (Vyskocilova et al., 2015), values clarification is an informative exercise for both a patient and their therapist. That is, values clarification can help a therapist better understand what a patient wants out of therapy (and life in general), but it can also do the same for a patient themselves, if their values were unconscious. Since value systems can be unconscious, values clarification can be helpful both in and out of a therapy setting.

 

15+ Examples Of Personal & Core Values

Some examples of personal values include (Frankl, 1963; Vyskocilova et al., 2015):

  • Creative values
    o Working
    o Creating things
  • Experiential values
    o Appreciating beauty (in nature, music, etc.)
    o Love
  • Attitudinal values
    o Attitudes towards inevitable events such as illness, death and loss
    o Views on morality
    o Views on the meaning of suffering
  • Relationship values
    o Valuing romantic partnerships
    o Valuing parent, child, and other family relationships
    o Valuing friendships
  • Achievement values
    o Valuing a career
    o Valuing education, professional, and personal growth
  • Recreation values
    o Valuing leisure, hobbies, and recreation
    o Valuing charity and volunteering
  • Health values
    o Valuing physical health
    o Valuing mental health
    o Valuing spirituality

Values Clarification: How Reflection On Core Values Is Used In CBT

 

The Influence Of Moral Dilemmas On A Value System

Moral dilemmas are a crucial aspect of development. In adolescence, people “develop their moral self-concept based on their daily life experience, where they have to make decisions and regulate their behaviours when coping with new challenges and social influences” (Paciello et al., 2013).

In other words, while they can be uncomfortable and harmful to relationships, moral dilemmas help people shape and refine their value systems by forcing them to think about their values.

Having well-identified and clarified values can help someone “reflect on moral dilemmas” (Vyskocilova et al., 2015). On the other hand, in people who do not have well-clarified values, or people who have conflicting values, moral dilemmas can lead to stress and anxiety, and even feelings of helplessness.

Values clarification is therefore a valuable tool which can help people refine their value systems in a low-risk environment, as opposed to having to refine one’s value system in a high-risk situation, such as when being faced with a moral dilemma in real life.

 

Values Clarification Approach In Therapy: 10 Exercises

A values clarification plan may consist of the following seven steps (Twohig & Crosby, 2008; Vyskocilova et al., 2015):

  1. Creating distance from social pressures: helping the patient distinguish between their own motivations and desires and those of the people and society around them.
  2. Defining the concept of values with the patient: explaining the difference between values and goals, such as the fact that values cannot be achieved like goals, but they can be used to set goals.
  3. Defining personal values: helping the patient identify their own personal values.
  4. Importance (significance) of individual values: helping the patient figure out how important each of their values is, relative to the others.
  5. Determining how the patient’s current actions are consistent with the relevant areas of values: having the patient self-evaluate how consistent their actions are with their values.
  6. Choosing immediate goals consistent with values: setting goals for the patient that are consistent with their values.
  7. Behaving in accordance with objectives and values: using CBT techniques, the therapist and patient try to keep the patient on target for their goals based on their values.

A values clarification plan specifically for chronic pain, on the other hand, might include these steps (Andersen et al., 2015):

  • Discussing important values with family or friends
  • Learning about how values can and should affect different areas of life
  • Discussing how values should help guide activity engagement, but psychological barriers can stop value-based activity engagement

 

3 Values Clarification Worksheets & Activities

For people who want to try values clarification for themselves or for their practice, here are some helpful worksheets:

Values Clarification from Therapist Aid

This worksheet has a long checklist of predefined values and instructs the user to select and rank the ten most important values to them. This worksheet serves to not only help people identify their values, but also allows them to figure out the relative importance of each value. This is an important step in understanding one’s value system.

Values Clarification from PsychPoint

This values clarification worksheet digs a little deeper than the above worksheet. It asks for one’s core values, but also asks about their parent’s core values and other aspects of one’s life, such as life lessons they’ve learned. This is a good way to learn someone’s core values, as well as a little bit about why they hold those values.

Clarifying Your Values

This is another values clarification worksheet, but it is more informative than the first two. The worksheet includes information about values clarification, and also discusses a values clarification exercise called The Bull’s Eye, where people can evaluate their commitment to their values in various aspects of their lives. This is a good option for anyone who wants to learn about values and values clarification in different life domains.

 

A Take Home Message

Values clarification is a crucial part of CBT, because it helps the therapist and the patient understand the end goal of treatment. Therapists can also use patient’s values to help convince them that lifestyle changes are worth the initial discomfort. Values clarification is not just important for CBT, though.

When we are unsure about our own values and morals, we risk a few negative outcomes. First of all, being unsure about our values can lead to stress and anxiety. Even worse, being unsure about our values can lead us to act contrary to our values, which can lead to even more stress and anxiety (along with guilt). For these reasons, it is important for all of us to know what our values are (whatever they may be) and act according to them.

  • References

    • Andersen, T.E., Ravn, S.L., Roessler, K.K. (2015). Value-based cognitive-behavioural therapy for the prevention of chronic whiplash associated disorders: protocol of a randomized controlled trial. BMC Muscoloskeletal Disorders, 16(1), 232. doi:10.1186/s12891-015-0687-y
    • Brabban, A., Byrne, R., Longden, E., Morrison, A.P. (2017). The importance of human relationships, ethics and recovery-oriented values in the delivery of CBT for people with psychosis. Psychosis-Psychological Social and Integrative Approaches, 9(2), 157-166. doi:10.1080/17522439.2016.1259648
    • Frankl, V.E. (1963). Man's search for meaning: an introduction to logotherapy. New York: Washington Square Press.
      Heapy, A.A., Wandner, L., Driscoll, M.A., LaChappelle, K., Czlapinski, R., Fenton, B.T., Piette, J.D., Aikens, J.E., Janevic, M.R., Kerns, R.D. (2018). Developing a typology of patient-generated behavioral goals for cognitive behavioral therapy for chronic pain (CBT-CP): classification and predicting outcomes. Journal of Behavioral Medicine, 41(2), 174-185. doi:10.1007/s10865-017-9885-4
    • Paciello, M., Fida, R., Tramontano, C., Cole, E., Cerniglia, L. (2013). Moral dilemma in adolescence: The role of alues, prosocial moral reasoning and moral disengagement in helping decision making. European Journal of Developmental Psychology, 10(2), 190-205. doi:10.1080/17405629.2012.759099
    • Twohig, M.P., Crosby J.M. (2008). Values Clarification. In O’Donohue, W.T., Fisher, J.E. (Eds.), Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice (2nd ed.) (583-588). Hoboken, NJ: Wiley & Sons
      Vyskocilova, J., Prasko, J., Ociskova, M., Sedlackova, Z., Mozny, P. (2015). Values and values work in cognitive behavioral therapy. Activitas Nervosa Superior Rediviva, 57(1-2), 40-48.
    • Wicksell, R.K., Ahlqvist, J., Bring, A., Melin, L., Olsson, G.L. (2007). Can Exposure and Acceptance Strategies Improve Functioning and Life Satisfaction in People with Chronic Pain and Whiplash-Associated Disorders (WAD)? A Randomized Controlled Trial. Cognitive Behaviour Therapy, 37(3), 169-182. doi:10.1080/16506070802078970

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