Pre-Session Briefing
Amara T. · 55, she/her · Complicated Grief · ACT · Session 10/14 · Fri, 4:00 PM
Last Session — Mar 28, 2026
Key Themes
- ▸Anniversary of husband's death approaching (April 12)
- ▸Explored values: connection and generosity emerged as central
- ▸Discussed how grief avoidance has narrowed her life (stopped volunteering, reduced contact with friends)
Interventions Used
- Values clarification exercise: life compass
- Defusion technique: 'I notice I'm having the thought that...'
- Committed action planning for anniversary week
Clinician Note
“Amara showed deep engagement with values work. The connection between grief avoidance and life narrowing landed powerfully — she said 'I've been hiding from sadness and losing everything else too.' Anniversary week will be clinically significant.”
Client Check-In
“Dr. Anand, I've been practicing the defusion thing and it's interesting. When I say 'I notice I'm having the thought that I can't do this without him,' it creates this tiny bit of space. It doesn't make the sadness go away but I feel less trapped by it. I decided to volunteer at the food bank on the anniversary. That's something we used to do together. I'm scared but it feels right.”
Journal Excerpts
Mar 30
Tried the defusion at the grocery store when I walked past the coffee he used to drink. 'I notice I'm having the thought that I can't do this.' It helped. I still cried in the car but I got through the store.
Apr 4
Called the food bank to sign up for April 12. My hands were shaking. The coordinator said they'd love to have me back. I haven't been since before he died.
Suggested Threads
Amara's decision to volunteer at the food bank on the anniversary represents a significant committed action — choosing to approach grief-associated activities rather than avoid them. Harris (2019) notes that anniversary-linked committed actions in ACT grief work are often watershed moments. Prepare for high emotional activation in next session.
Source: Domain knowledge: Harris's ACT for Grief and Loss
Defusion technique showing functional impact. Amara reports it creates 'a tiny bit of space' — not eliminating grief but reducing experiential avoidance. Defusion practice adherence 86% this week.
Source: Between-session data
Mood dips on Tuesdays and Saturdays across last 3 weeks. Tuesday was the day Amara's husband passed. Saturday is when they used to volunteer together. These temporal patterns may intensify as anniversary approaches.
Source: Longitudinal analysis
Mood This Week
Avg: 4.0/10
Homework Status
6/7
1/1
5/7
Treatment Progress
Session 10 of 14· Started Jan 24, 2026