THE ACT MATRIX - praxis-cet.s3-us-west-1.amazonaws.com€¦ · THE ACT MATRIX AN ADAPTABLE...
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THE ACT MATRIXAN ADAPTABLE APPLICATION OF
ACCEPTANCE AND COMMITMENT THERAPY
Lou Lasprugato, MFT
ACBS ACT Trainer
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DISCLOSURES
• Relevant (financial) relationships for Lou Lasprugato
• Employed at Sutter Health’s Institute for Health & Healing
• Provides training events for Praxis Continuing Education
• Maintains a private practice in Davis, California
• Provides individual coaching and consultation
• All photos and images within presentation were labeled
for reuse, cited, and/or used with permission
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LEARNING OBJECTIVES
1. Perform a functional contextual assessment of
behavior with The ACT Matrix
2. Utilize The Matrix to formulate and deliver
therapeutic interventions
3. Undermine unworkable experiential avoidance
(i.e. ‘stuck loops’) and reinforce values-guided
action through augmenting
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FIRST THINGS FIRST:WHAT IS ACT?
“In theoretical and process terms we can
define ACT as a psychological intervention
based on modern behavioral psychology,
including Relational Frame Theory, that
applies mindfulness and acceptance
processes, and commitment and behavior
change processes, to the creation of
psychological flexibility.”
- Steven Hayes, ACT co-founder
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PSYCHOLOGICAL FLEXIBILITY
• Overarching aim of ACT is to enhance
psychological flexibility:
• “The ability to contact the present moment
more fully as a conscious human being, and
to change or persist in behavior when it
serves valued ends.”
• Biglan, Hayes, & Pistorello, 2008
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ACT MATRIX OVERVIEW
• The Matrix is a point-of-view designed to
cue psychological flexibility by noticing and
sorting the differences between:
• Moving toward values vs. away from painful
private events (i.e. function of behavior)
• Outer (overt) vs. inner (covert) behavior
(i.e. context of experience)
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TowardAway
Outer
Inner
ACT Matrix
Adapted from K. Polk, J. Hambright, & M. Webster
PurposePainNoticing
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Outer
Inner
ACT Matrix
Conte
xt
of
Experi
ence
Covert Behavior:What we think, feel, and
sense within our skin
Overt Behavior:What we see, hear, touch, taste,
smell, and do with our body
Functions of outer experience can be transferred onto inner
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ACT Matrix
Function of BehaviorAway Toward
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TowardAway
ACT Matrix
Painful private events:Uncomfortable thoughts, urges,
emotions and sensations
Values:Freely chosen qualities of action
Desired ways of behaving
Behaviors under aversive controlof painful private events
Behaviors under appetitive controlof values
Negative
Reinforcement
Positive
Reinforcement
Stuck Loop: short-term relief but unworkable in long-run
Pain Purpose
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TowardAway
Outer
Inner
ACT Matrix
Painful private events:Uncomfortable thoughts, urges,
emotions and sensations
Behaviors under aversive controlof painful private events
Behaviors under appetitive controlof values
ObservingSelf
Values:Freely chosen qualities of action
Desired ways of behaving
PurposePain
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CASE PRESENTATION
• 40yo adult black female nurse and mother of two young
children feeling overwhelmed during the pandemic. She
reports heightened anxiety, including frequent worry, as
well as binge-eating and purging, which evokes shame and
self-criticism. Recent racial protests have triggered
flashbacks and nightmares related to being harassed by
peers at predominantly white school during childhood.
She now avoids news/social media, but misses interaction
with friends and would like to work towards racial justice.
She cares about being helpful to others and wishes she
was more playful and present with her kids. She previously
enjoyed creating art and going on bike rides with them.
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NoticingTowardAway
Outer
Inner
ACT Matrix Case Conceptualization
OverwhelmedAnxiousFrequent worryShame / self-criticismFlashbacks / nightmaresSadness (misses interaction)
Binge-eatingPurgingAvoids newsAvoids social media
Making art with kidsFamily bike ridesInteracting with friendsHelpful behaviors as nurse?Actions of racial justice?
HelpfulPlayfulPresentCreativeRacial justiceSocial connection
Pain Purpose
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NoticingAway
OuterACT Matrix
What thoughts and feelingstend to hook you (get in the wayof moving toward your values)?
What are your heart’s deepest desiresfor how you want to live your life?
What do you want to stand for?
What do you do to get away (relief) from (or when under the influence of) this (pain)?
What have you done (could you do)to move toward (act on) your values?
Clinical Interview
Toward
Inner
PurposePain
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VERBAL AIKIDO (YES AND…)
• Verbal Aikido: receiving and then redirecting
energy into noticing, sorting, and choosing*
• And where would that go on the Matrix?
• And what do you do in the presence of …?
• And what effects have you noticed from…?
• Are you willing to carry this (pain) with you as
you move in that valued direction?
• If it meant living the life you long to live?
* Polk, Schoendorff, Webster, & Olaz (2016).
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VERBAL AIKIDO FOR AWAY MOVESTRANSFORMING FUNCTION
• First validate ‘Away moves’ and short-term
payoffs (negative reinforcement) with respect
to context (situational, historical, evolution)
• Then assess long-term effects (costs)
• Have any of these ‘Away moves’ eliminated
your painful thoughts/feelings in the long run?
• Have any of these ‘Away moves’ made them
worse over time or created new problems?
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VERBAL AIKIDO FOR TOWARD MOVESAUGMENTING FUNCTION
• Augment: connect actions to intrinsic and
overarching sources of reinforcement (values)
• What qualities (of who you want to be) are you
enacting in this ‘Toward move’?
• What would this ‘Toward move’ be in the
service of? How is this meaningful to you?
• How might these ‘Toward moves’ bring more
fulfillment to your life in the long run?
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NoticingTowardAway
OuterACT Matrix
What difficult thoughts & feelingshave been coming up for you
during the pandemic?
How do you want to treat yourselfand others during these times?What do you want to stand for?
What do you do to avoid(get away from) this (pain)?
What would we see you doing?
What do (could) you do toact on (move toward) these values?
What would we see you doing?
Practice
Inner
Pain Purpose
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TowardAway
OuterACT Matrix
Noticing
-
-
-
- -
Inner
Practice
PurposePain
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NoticingTowardAway
Outer
Inner
ACT Matrix
PsychologicalFlexibility
Contact with the Present Moment
Acceptance
Defusion
Self-As-Context
Committed Action
Values
Treatment Planning
Be aware of experience
Open up to what shows up
See thoughts as they are
Do what it takes
Embrace what matters
Connect with experience
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LIFE WITH THE MATRIX:WHERE TO BEGIN
• Non-judgmentally notice when you are:
• In your head vs. out in the world
• Moving toward values vs. away from pain
• Caution: ‘toward/away’ is NOT ‘good/bad’
• Goal is to build psychological flexibility
• Choosing to do what matters, even in the
presence of difficult experiences
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“I’ve been absolutely terrified every moment of
my life, and I’ve never let it keep me from
doing a single thing I wanted to do.”
Georgia O’Keeffe
Image: pinterest.com
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ACT (MATRIX) RESOURCES
• The Essential Guide to the ACT Matrix
• Authors: Polk, Schoendorff, Webster, Olaz
• YouTube Channels on The Matrix
• New Take Therapy; Timothy Gordon; Dr. Kevin Polk
• Learning ACT Resource Guide
• portlandpsychotherapytraining.com/guide-to-learning-act/
• Apps
• ACT Coach (National Center for PTSD)
• ACT Companion: The Happiness Trap App
• Audio (mp3) exercises
• actwithcompassion.com: mindfulness/self-compassion
• thehappinesstrap.com: Russ Harris guided meditations