Exposure to Privilege

Exposure to Privilege

The Function of Privilege within Our Science and Beyond

Angela Cathey, MA, LPA

If you’re familiar with my writing or social media, you are probably familiar with my tendency to advocate for the underrepresented and disempowered in our society. Recently, I’ve found myself in a Facebook debate about this, in my social feed, that warrants a more elaborate response. I am also a woman, in a science dominated by men in power positions, who continually seek to ‘educate’ me further when I disagree with them. So, read this post with all that in mind.

First, I’d like to acknowledge that posts on Facebook conversations are not an adequate medium for debate. Without our voices, without posture, and without other cues that reflect the complexity of our perspective we are virtually guaranteed to keep arguing even when we agree. Our specific wording, the individual’s perception of us, and the nature of the media itself are likely to drive the other’s responses more than what we’re intending to express. This is simply a result of how the contextual variables inherent in social media (e.g., anonymity, slow responsivity, lack of complexity, and a public venue) tend to function for us.

We are faceless, sometimes nameless, words on paper expressing complex ideas in bumper sticker length responses. This is in part why social media results in long, sometimes heated, and often pointless debates so frequently. We are not faced with the person behind the idea, the whole idea, cues about the person’s emotion – and are left responding mostly to our relata and words that are themselves varied in function. We miss the complexity of other’s ideas, knowledge, and experiences. This is, in large part, how words, and people, function out of context.

The post I made that began the debate was a repost of a USA Today post, entitled “All college students should take a mandatory course on black history and white privilege.” I will attempt not to recount the debate here in detail, name the individual, nor shame the individual for their perspective. I choose to believe that the individual is arguing because they, like myself, believe that our science can do a better job of moving the world forward. I choose to see us as on the same side. What occurred in the debate; however, encapsulates why I believe that our society needs “mandatory” exposure to the ideas and experiences of others and the impact of “privilege.”

We are all privileged and disadvantaged in some ways; however, those with less power in our society frequently have no way to express their perspectives without it being perceived as punishing to the majority. This is, in part, the essence of privilege. Those with power and privilege see their perspective represented all around them in their everyday experience. Those with power and privilege are more likely than those without, to be surrounded by people and experiences that reinforce their beliefs about themselves and others. Those without privilege are faced with few representations of themselves, punishing representations of themselves by the majority, and to find themselves represented in and responded to – as caricatures.

In some ways, being an underrepresented minority in like attempting to express complex ideas, about heated topics, on social media. The underrepresented are prone to be responded to based on relata. The complexity of their ‘selves’ (instead of their idea) responded to with hostility because their ‘otherness’ does not fit neatly into the boxes of those with the dominant view.

This is the influence of verbal symbolic rules, how they function interpersonally, and why I believe we should all be constantly exposed to the perspectives of others. We, in particular, need experiential exposure to minority perspectives in as many forms as possible. Some of these are going to be punishing for us, some of them are going to be overwhelming, and some of them are going to be affirming. And, we need to realize as a society that all of this is important for us to experience for our collective good. A course in white privilege or black history is a drop in the bucket. It may function for many aversively, and yet, we have to start embedding the minority experience in the lives of the majority. We are a society moving further and further away from complexity and existing in worlds that function as echo chambers. Within social media, within science, and within society – most of us have the privilege of being able to ‘unlike’, ignore, and benefit from the inherent reinforcement of our views from the dominant representations of our views surrounding us.

This is why exposure to the perspectives of disempowered minorities must be in some way “mandatory.” The coherence of those with significant privilege, in any form, is reinforced simply by existing in a world that endorses their perspective on nearly every level of their existence, all day, every day. The privileged have no reason, on mass, to decide to hear and appreciate the complexity of the minority experience. It tends to violate the sense of ‘self’ of the privileged to even hear that they/we are privileged. My colleague who debates me recognizes this and yet misses the complexity of my argument for mandatory exposure to the perspectives of minorities and our privilege.

True recognition of privilege and the perspectives of minorities that will create change means creating interventions that are embedded throughout our society. It means that media is created by minorities, it means that representations of the perspectives of minorities are embedded into our society in so many ways that they become not the expressions of an unknown caricature “other” but as part of our collective view of ourselves, our history, and our ability to change, together.

And, for the one who inspired the post, if the complexity of my perspective results in further attempts to correct me by insisting I simply need education on the basis of our science, on my feed, don’t be surprised if you get a more explicit public lesson on male privilege in our field and how your behavior functions aversively as ‘mansplaining.’ I am the female owner of a behavior analytic education site who disagrees with you, insisting that I need to educate myself in single-case design, reinforcement, and punishment because I disagree with you –  without stepping back to consider the context surrounding your behavior is an act of privilege in action.

 

RFT: Let me show you something beautiful.

RFT: Let me show you something beautiful.

AUGUST 11, 2016, original post to angela.cathey.com

Stop over thinking RFT and feel it.

I would say that sometimes it takes a different perspective to look at the tools we are given and see them quite differently. We, the second and third generation ACTers, FAPers, and rising CFTers… we are reveling, rejecting, remixing, and refining the elegance of technical masterpieces.

So, here is one of my remixes. I don’t like connecting with RFT in examples of coin size, driving, or equations about how cats = “cats” and … =Screen Shot 2016-08-03 at 11.03.28 PM

Okay, he’s cute. I’ll give you that… but he’s still a cat.

RFT is the rhythm of human thought and feeling. Just because the Internet is officially full of cats. doesn’t mean that our conceptualizations of human thought and language should be. (No offense to the cat lovers or Schrode’ [inside joke]}

So what is more human? Art.

Here’s a different way of connecting with frames. Take a moment to look at the picture below. Notice.

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Feel your eyes pulled to the highest point? The background falling away into fuzziness. There’s a feeling of being pulled upward higher. This is a visual metaphor for how a hierarchical functions. This is what connecting with values, belonging, purpose… does to your sense of the world. You tune into the higher point and the rest falls away into the distance.

Now, look at this picture.

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Notice how the pieces fall away and the whole pops forth? You notice the togetherness, the uniformity of what is actually separate pieces. When we feel in coordination with something we move towards it, we identify with it, we become in some way a reflection of the other. (This is also a bit hierarchical, but “frames” are always functional concepts so let’s stick with what ‘works’.)

Now look at this picture.

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Maybe you could technically ‘see’ that this is tree bark but that’s not likely to be what you were paying attention to. Context sensitivity is like zooming in. You see the details. You experience, and you might be hyper- sensitive to a change in the context. For example, a giant ladybug landing in the middle of this might jolt your attention more so if you’re more contextually sensitive in-the-moment.

Now look at this picture.

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This is a visual metaphor for coherence. See how your mind likes the fitting together of randomness into a pattern? It’s naturally reinforcing. People don’t like messes.

Now look at this:

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This is a bit like the concept of adaptive peaks. Sometimes we can miss the forest, sunrise, and distance when we’re focusing on making wishes on the dandelions we can see in the immediate path.

 

If you like learning about Relational Frame Theory, behavior analysis, principles, or the philosophy of science in different forms – let us know in the comments. If you’d like to learn more feel free to check our selection of online, on-demand, and live training events.

RFT: The Guerilla guide to pro-social change

RFT: The Guerilla guide to pro-social change

Original post to angelacathey.com, July 2016

Welcome to Frame Club. A Guerilla guide to pro-social change with RFT.

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The world is full of simple repetitive messaging. Everything is a bumper sticker. “Party A is evil, party B is good” and…. shootingsdiscriminationand ignorance follow.

Life and people aren’t bumper stickers. 

The repetitive simple messaging we’re privy to means that we’re deriving copies of copies of copies. That’s not good.  We’re also used to this and insensitive at times to direct contact contingencies. So, we get around rules in other ways for instance politicians can now move us more effectively through associative frame speak than through direct logic (eh hem… Drumpf for President anyone?).

And yet, we’re not doomed to idiocracy.

We know that simple low complexity derivation begets 1) rules, which leads to 2) unawareness (rule-governed insensitivity to contingencies).

When you add to that mix pain, you get: 1) avoidance, that leads of course to resilient and contagious ideas. This is why we teach acceptance by metaphor and experience. You can’t just say “accept” because you end up with a useless rigid rule and lack of awareness of the contingencies around it.

So, let’s acknowledge what’s there and why it’s there.

We all have histories of learning negative discriminatory relations about race, sex, gender, social class, body image, and a whole host of other things.

Even if they weren’t outright stated (aka you didn’t hear racist, sexist, anti-gay messaging regularly) simple repetition of any situation creates rules which spread in our minds in a variety of ways. We then deal with this in predictable ways.

Some of these rules may come about just through noticing differences and similarities between ourselves and others (Roche, Barnes-Holmes, Barnes-Holmes, Stewart, and O’Hora, 2002) and this influences our behavior.

So, we’re going to have these relations as a bi-product of our natural tendencies to categorize and organize our worlds (if we didn’t life would be a bit like 50 first dates. Where everything would be new and foreign each time we contacted it. That’s not workable. )

We’re going to have these rules in our heads about people that are painful as a result of living. We can try to wish them away but that’s just going to result in rules in the other direction then create insensitivity to direct contingencies (even if they’re as big as a gorilla in the room.)

Unfortunately, there is no erasing of relations. We all have painful thoughts that we’d rather not acknowledge.

Luckily, there’s been some great work on what this is in the social realm and what we can do about it (see Vilardaga, Levin, Hildebrant, Hayes, & Yadavia 2008, May ABA – need to log into ACBS for access) or Vilardaga, Hayes, Levin 2014 – The Flexible Connectedness Model).

We can deal with relations that are problematic in a variety of ways.

In some cases, we can simply derive new more complex relations that fade the old relations in importance; however, when the rule is more stubborn (i.e, involves any pain as it so often does when rules latch on to humans) this often won’t be enough.

We often need a shift in context (defusion, mindfulness of the contingencies of that drive our behavior in non-rule-based form). We can also combine these with combinations of context shift like this Deictic Framing Exercise (exercise by Vilardaga, Levin, Hayes, 2008 – video by Gareth Holman). This type of exercise combines several relations that move us past rule-based insensitivity including shifts in deictic and deictic related framing (temporal, hierarchial, etc.).

 This is likely to work for those who are willing to engage. 

However, we know that coherence, simplicity, avoidance of pain… all of this is self-reinforcing and we can’t expect a large portion of the population to sit down and do a perspective-taking exercise just yet. So, what can we do?

 Adapt the message or the context.

If argumentation and rule-based insensitivity are likely you need to adapt the message. Go metaphorical, go high complexity, and go associative. Feelings aren’t as easily blocked (see every perfume commercial ever made.)

Or shift the context, humor can work well at getting our attention when insensitivity is the norm (see Old Spice Muscle Pump  commercials that get our attention when we normally tune commercials out).

When humor, feeling, metaphor, aren’t practical and/or the consequences are too high, we can also reduce the accessibility of Sds (discriminative stimuli) if we know what’s pulling the problematic frames. We could be enacting this in some of our institutions (e.g., the justice system) now. We know the impact of race on judgments and sentencing and yet we just keep sending people into the justice system and pretending human bias isn’t there. When are we going to just start recognizing and adjusting to human bias tendencies to protect people? We’ll tend to engage in mass scale rule-based insensitivity to avoid contacting what’s difficult (see the DARE program and abstinence education for policies that continue to be funded despite their widely recognized ineffectiveness).

Contextual Behavioral Science and RFT can begin to mindfully examine these contingencies if we take the time to look at what’s going on with a stance of self-other compassion without blaming or shaming either party we can start from a new context where together we step forward to understand what keeps us stuck hurting ourselves and each other.

You and I: Understanding and measuring high impact Functional Analytic Psychotherapy (FAP)

You and I: Understanding and measuring high impact Functional Analytic Psychotherapy (FAP)

Original Post to AngelaCathey.com on July 24th, 2016
by Angela Cathey

There are many ways to understand every therapy. Here I’ll offer a granular analysis of what seems to occur in the high impact FAP. What I present here is not an opposition to the current model of FAP but a different layer of analysis. I would agree that contingent reinforcement of behavior is a key mechanism of FAP. The purpose of an RFT-level analysis is to offer additional ways to measure and understand some of the effects of FAP that are otherwise difficult to characterize and measure.

I’m focusing on the symbolic relations that are created in what I call ‘high impact’ FAP. What I’m calling to in this description is the tendency of present moment relational therapy to become more powerful and evocative than one would normally suspect of a treatment based on reinforcement of adaptive behavior via the therapeutic relationship.

Those of you who have been to a FAP intensive or are highly experienced in FAP may be familiar with the report of FAP being “life-changing”, “transformative”, etc. To some extent one would hope most treatments are experienced this way; however, the rate which participants report intense response to FAP is likely higher. And, an RFT driven analysis there are empirical logical explanations for why those that experience FAP as moving may experience it as life-altering.)

Note that RFT is about symbolic relations and their properties. Patterns of pairing (between behavior, language in any form, sensations/perceptions, contexts) can all become meaningful over time through association with important (e.g., painful, joyful) experiences.

This is no different than operant reinforcement or classical conditioning – the type of pairing, the frequency/schedule, context, etc. all affect the relations made. The only difference here is that the SD can show up more easily symbolically (via language or some other cue).

So, let’s now look at perspective (the “I”) that orients your experience. You walk through life each day seeing, doing, feeling, thinking… and each of these things becomes a part of your continuing experience. In some way, they have become paired with the “I”. Perhaps very weakly paired but paired none the less. (See RFT: The space-time of the human universe for further description of perspective).

Experiences that happen over and over, including consistencies in the way that people describe you or relate to you become a part of your “I” and your concept of the other, or symbolic “YOU”.

The way you explain what occurs in these relations gives them additional power as it becomes a symbolically ‘sticky’ way of seeing the world (i.e., coherence relations, schema). You see others through this story of yourself and yourself as well. They, similarly, have stories about themselves and others and how people relate by which they organize their experience.

Now consider that everything you do in a relationship creates associations between:

The “YOU” and “I” present, or symbolically referenced (spoken about, etc.). Further, the emotions you express, the way that you talk about yourself and others, the behaviors you emit in any respect all become attached to the “YOUs” and “Is” in the room. (Yes, plural “I”s through the sometimes distinct tracks of symbolically defined behavior (e.g., roles, contexts, etc.) serving to create classes of behavior that ‘hang’ together.

Stop and consider that for a bit… Do you often belittle yourself in your own mind or in front of others? If you do you may find that people’s behavior towards you will begin to reflect this relation or that your own behavior towards your self will become less compassionate over time.

Our learning histories, ‘sticky’self-stories, and current histories all affect our sense of self and other. And, because the “I” is theoretically the relation most complexly derived (it is always there as a part of the associations forming) transformation of the “I” can ripple through all the attached relations.

Stop and think for a minute. All your sensory experience, all your visual perceptions, all your everything is hooked right through that “I” relation. So, what if it is altered? What will you experience?

If the alteration is “good”, perhaps you feel like this?

Now let’s switch to thinking about the process of an intimate relationship, using a lovely cheesy music video metaphor that we’ll then build upon both these to discuss the complex symbolic relating that can occur in high impact FAP.

Do watch as it will help you connect to the symbolic journey we’re going on through metaphor. The Story of My Life

Imagine that the moments of your life are pictures. The experiences that reflect complexity (ERRRs) most often are a series of pictures with richly emotional colorful (good or bad) details. See the birth of your child, and the hundreds of pictures to capture the complex experiences that follow.

Now, look around your home… are there single large photos blown up… special moments you wanted to save. These are likely snapshots of complexly derived moments (see the pictures from Hawaii… feel the sand beneath your toes? Sometimes complexity is lovely.

Now there are thousands of random shots in between that capture random moments, important relationships, accomplishments… and because this is your life, not a photo album imagine that all the moments you never wanted to remember are also there. In their full, and sometimes awful glory.

That time you fell on your ass in front of a crowd…

Your worst mistakes. All of them are memorialized in all their complex and highly derived glory (because rumination derives!) in big lovely photographs you keep hidden away.

All these moments that form the history of you, your pain, your joys, your disappointments… see them all strung along the wall back behind you (in time).

Now imagine opening your heart and mind to pull out these photographs and show another. Each time that you hand a painful or joyful memory to this person a connection between you forms, a connection between both of you and the memories seen, the emotional expressions of both (YOU and I) then shape the memories and the relationship. There’s a heck of a lot of relating going on here – temporal, deictic, high complexity, transformation of stimulus functions through coordination/distinction/opposition with the other.

And, this… is just a close relationship. This isn’t even therapy.

Notice how we all are deeply affected by our relations, good or bad, to those around us.

People are a core of our experience, our ‘self’, and our world.

Now, let’s work towards understanding the complexities of high impact Functional Analytic Psychotherapy relating.

Open this and listen while you Imagine.

Let’s walk through a super simplified course of FAP via the special case of intensives. For the unfamiliar, this is 3-4 day long training of therapists who come to hone their skills together by experiential practice.

Much like most FAP treatment itself it generally begins with some sort of Life History or discussion of adaptive (CRB2) and maladaptive (CRB1) behaviors. The very discussion pulls the relations along from the past, symbolically, to accompany the present. The power of the past (pain and joy) becomes more accessible by relation.

Now you begin to hand not the pictures described above but your real present moment experience (that is sometimes still fused with pain) to your colleagues. You may be brought to tears by the transformation of stimulus functions simply involved in discussing your pain and struggles in front of another.

As you engage in this interaction the other makes out-to-in parallels creating a symbolic I-YOU relation linking to the past relations involved (to people and behaviors that can be present in the now for changing).

In doing this, you are allowing the present moment interaction to alter contingencies set in other relationships because the attachment of past and present I-YOU to in the moment I-YOU is like creating a transcendent I-YOU.

The impact of the learning experience naturally becomes stronger as the symbolically present and in vivo relations combine. Anything altered through reinforcement or otherwise, can now affect the past, the present, the “I” and the “YOU” in the present, and all other “Is” and “YOUs” relevant to these relations.

At this point, contingent reinforcement takes on a new life. You’re shaping behavior but you’re also shaping relations, which allows you to interact with and shape someone’s relating to what occurred long with someone else. The shaping of that entire chain of relation can in a sense begin to over-write the relations of the self, the other, and the world.

The result can be “magic” and leave people changed. A present moment, relational therapy, driven by behaviorism. This is powerful medicine (not without its challenges).

Intensives, in particular, may evoke strong reactions as days of present moment relating in a uniquely supportive environment while bringing in other relations and experiencing the transformation of pain from long ago… it’s a bit like flooding of the deictic relations with new, hopefully adaptive, learning.

What are your thoughts on this and the complications of what we’re describing? Let us know in the comments. If you’re interested in more writing on clincial behavior analysis, RFT, principles, or the philosophy of science – let us know. Also, check out our selection on-line, on-demand, and live training on related topics!

Human Attachment: The ‘Why’ of Connection

Human Attachment: The ‘Why’ of Connection

Attachment and Cooperation

by Broderick Sawyer, PhD

When we want to improve upon our ability to reach any mutual goal that involves more than one person- businesses, sports teams, government, and even 1 on 1 personal relationships- attachment theory can be particularly helpful in improving human cooperation.

Attachment Theory is more complicated than any one article, but when we focus on the process of building human relationships and day to day interacting, it becomes clear that this process is largely responsible for how we feel about ourselves, which then influences how we interact with others. That is to say: Self-image = how we feel others perceive us.

Our gift as human beings is our ability to fit into and contribute to social groups effectively, without rocking the preverbal boat by interacting in ways that are not conducive to the interaction ‘style’ of the group. If we imagine our brains as computers that need to be programmed so that we can have a final ‘version’ of ourselves by adulthood, it would then be obvious that our childhood, adolescent, and early adulthood experiences have much to do with developing our social style, via developing our self-image.

While genetics do predict certain predispositions to certain ways of behaving, let me dispel the myth that genetic traits predict who we are all the way throughout adulthood and drive humans to become ‘fixed’ beings. This is nonsense, and backed by what we call ‘neuroplasticity’: the ability of the brain to adapt to the input that it is receiving at every moment throughout our lives. If we change our environment, the people we interact with, or if bad things happen to us, our brain literally creates NEW neural pathways to adapt to new circumstances. Why does it seem like we can become ‘fixed’? Well, the more we continue on in our current circumstances, these neural pathways become stronger, which causes whatever behavior we are doing to become more of habit and way easier to do- rather than change.

One thing, however, is fixed. We all have the same capabilities for honest, compassion-driven communication, but unfortunately, evolution does not care about our abilities to be compassionate, rather, our continuing to breathe, eat, sleep, and reproduce. This does not necessarily require compassionate interaction. Thankfully, the world of psychology is a developing field that can provide us various loopholes to develop a more compassionate style of interaction, and this starts with understanding various “styles” of interacting, how they came to develop, and what this means for our interactions with others as adults.

A challenge to our readers, can you drop to the level of Relational Frame Theory and Behavior Analysis and provide an account of what’s described above in behavior analytic language?

What drives us to attachment? What maintains attachment styles? What do you see ‘underneath the hood’ in your language?

Are you interested in learning more about principles, behavior analysis, RFT, and taking an integrative look at our field? Let us know in the comments and check out our online, on-demand events!

Measurement: Why we get no R.E.S.P.E.C.T.

Measurement: Why we get no R.E.S.P.E.C.T.

“MEASUREMENT: WHY WE GET NO R.E.S.P.E.C.T.”

Psychologists, therapists, researchers in mental health:

How many times have you been at a party and told someone you’re a psychologist only to hear, “So, you can read my mind?”… or, “Can you analyze my dreams for me?”

Why does this happen?

The public has no idea what we do. At best, we’re often perceived as paid friends or mistaken for psychiatrists.

And, maybe we can live with this but it isn’t just the public. 

The National Institute of Mental Health (NIMH) is a major funder of our research… or it used to be. The recent move towards Research Domain Criteria Initiative (RDoC) for NIH funding means that obtaining a grant for an RCT from the NIH requires that you heavily integrate investigation of possible biological factors in your study to obtain funding. This has occurred despite the fact that most of the field (psychology) agrees that biological components aren’t driving contributors in most maladaptive behavior. In fact, years of searching for specific biological profiles for diagnoses has turned up little useful information. Still we’re on the search for the right blood test, fMRI, EEG, or otherwise, that will diagnose people, why?

Because – it makes what we do ‘real’ for them.  

So, what are the consequences of this search for ‘real’… thing-y-ness in mental health?

If you’re a clinician, not seeking research funding, you may not immediately contact what this means for you. So, here’s my take: If you’re using Beckian-CBT or even ACT, you’re probably fine. We’ve already got loads of RCTs to show these ‘work’. This means you can probably count on insurance companies giving you less of a hassle for treatment reimbursement.

If, by chance, you are using anything else that has had few RCTs you might have problems eventually. If we can’t get said treatment determined an ‘Empirically Supported Treatment’ through the current standard of massive and repeated RCTs. (Eh hem.. FAP. One of the most behavior analytic in-the-moment treatments struggles with RCTs because they are based on our most effective tool (functional analysis). Functional analysis is ideographic and doesn’t easily conform to RCT methodology. This is part of the reason for the build out of the ACL model… a need to standardize functional analysis. )

Well, I’m sorry but if we have to alter a treatment that is driven by a tool we all respect then our overall measurement/methodology strategy sucks. In fact, psychoanalysts were saying this about RCTs from the beginning but when we were in a foot race with them it was a little hard to hear the truth in it.

So, what I’m getting at here is several levels of pervasive problems related to our field… but thankfully, they’re related. 

Some of you may not like what I say here. I fully expect to get a few angry emails (Save it, prove me wrong with data.).

So, here’s my analysis of what’s causing these problems:

In a word: Measurement!

In a few words: Reifying rigidity! Constructs! and lack of integration!

Okay, so I’m probably at a level of geekery here that few will understand. So, this is what I’m talking about.

So, why am I picking on constructs?

We all use constructs. We have to so we can get through the day. Clinicians can’t walk around explaining to each other from the ground-up what “psychological flexibility”, “response flexibility”, “borderline”, “depression”, or anything means. That’s impractical but we do need to continually contact the effect of this on our methods and the perception of the world. Then we need to choose our level of analysis appropriately.

If we assess only at the level of constructs without awareness of the consequences then we’re essentially shooting ourselves in the foot. 

We’ve measured mostly in constructs because measuring real behavior was HARD. We know that behavior and report of behavior vary by context (e.g., mood state bias, retrospective report bias, rule-governed behavior, and the list goes on…) so we’ve tried to standardize the heck out of measures. We’ve measured mid-level concepts that attempt to represent whole clusters of supposedly important relationships. Then, because the public wouldn’t understand this… we have to integrate symptom inventories to give it some ‘realness’. It’s a chain reaction.

When we measure constructs we need them to hold still and mean something so we apply psychometric rules that assume thing-y-ness and stability to these airy clouds of invention. Then we make it ‘real’ with symptom inventories that use diagnostic labels that the public gets, but which we know have poor as hell diagnostic reliability (not surprising since they are essentially Chinese menu style creations. Congrats! pick 5 out of 7 and ooo. la. la. you’re depressed.)

Before you get ‘depressed’ reading this let’s take a ‘beginner’s mind’ to assessment (as Todd Kashdan suggests) and look at how we can fix these problems. 

Let’s build from the ground up. 

Let’s understand our assumptions and what works. Let’s start by measuring behavior, in context, across contexts. 

Contextual Behavioral Science has been moving towards this for years. Some of our brightest minds in theory, philosophy of science, treatment, and methodology have been telling us to go there for years (e.g., Roger Vilardaga, Kelly Koerner, Todd Kashdan, Kelly Wilson, and many others.)

For the interested, here are a few citations:

Wilson, Hayes, Gregg, & Zettle (2001). Psychopathology and Psychotherapy (Chapter in Big Purple).

Wilson (2001). Some notes on constructs: Types and validation from a contextual behavioral perspective

Hughes, Barnes-Holmes, & Vahey (2012). Holding onto our functional roots while exploring new intellectual islands: A voyage through implicit cognition research ***The Relational Elaboration Coherence model and RFT based assessment***

Vilardaga, Bricker, & McDonell (2014). The promise of mobile technologies and single case study designs for the study of individuals in their natural environments.

Iwata, DeLeon, & Roscoe (2013) The FAST. Functional Analysis Screening Tool

Hurl, Wrightman, Hayes, & Virues-Ortega (2016). Does a pre-intervention functional assessment increase intervention effectiveness? A meta-analysis of within-subject interrupted time-series studies. (**Spoiler alert: Yes, it does.**)

Since you probably didn’t click on any of those:

We have better methods now. We can use technology to assess behavior (across contexts), to intervene, and to rapidly and cheaply assess behavior. Take a moment: Look at your iPhone… That thing ‘knows’ more about you than your best friend or your spouse.

So, why aren’t we using these methods? Well, I hear you. Most of us weren’t taught to create Apps in grad school, to deal with data flow that exceeds the capability of SPSS, or to understand the intersection between technology and confidentiality. For most of us, even though we let Target (who lost tons of credit card numbers. yikes!), Apple, Best Buy, Netflix, and many others track our every move we’re not utilizing this technology well in the behavioral sciences.

Essentially: Who has time to learn entire new areas of science (App design, UX, Data Science, Python, R, etc.)  in order to have better and cheaper assessment? 

It’s not that people aren’t trying. I certainly heard a lot of interest in Ecological Momentary Assessment (EMA), Ecological Momentary Intervention (EMI), Relational Frame Theory, and links from basic to applied at the CBS conference this year but these things aren’t exactly user- friendly straight out the ‘box.’

Notably: There have been some valiant efforts to create systems of assessment and data tracking that ‘work’ for clinicians and researchers.

See:

Learn2ACT an integrated system of Acceptance and Commitment Therapy (ACT) driven mobile client-client centered data collection and intervention. It tracks and logs data for multiple clients and displays it for clinicians. Big props to Ellen & Bart for taking this on from programming to testing. Release of this product is currently scheduled for some time in Fall (so show them some love and for doing all this work for us)!

Other systems in development include Matrix (ACT-driven) Apps out of Mike Levin and Beniji Schoendorff’s groups. Roger Vilardarga and Jonathan Bricker and others also have out Apps that are a bit more target specific (e.g., ACT driven for psychosis, smoking cessation, etc.) – (Forward me links to anything else that is evidence-based or getting that way and I’ll consider listing them too.)

The process of gaining an evidence base for this technology (Mental Health Smart Phone Apps: Review and evidence-based recommendations for the future development), while mastering all this tech, and paying attention to user experience (UX) AND getting people aware of these technologies is a difficult one. So, as a community I think we need to support efforts to develop technologies that make it easier for clinicians and researchers to use functional contextual behavioral assessment.

I’m working on an integrated functional analysis driven assessment platform and I need your feedback. 

My concept is a bit different but also includes EMA/EMI, as this is our best CBS consistent context sensitive assessment effort thus far.

Stay with me here:

I propose that we also go from basic research and theory and build a system that integrates what we know to the best of our ability. One that is functional analysis driven, contextually-sensitive, rapid, and user-friendly. Then we make this available such that we can funnel meta data (read de-identified behavioral data on relations) to basic and applied researchers from clinicians. After all, those RCTs aren’t even touching how to treat complicated multi-problem clients.  

Such a system would involve:

  1. Contextualized behavioral assessment (EMA/EMI and passive assessment of biometrics. Hey, we’re not going to bowl the NIH and RDOC over all at once.)
  2. Assessment of verbal/symbolic related behavior (aka… integrating what we know from RFT into understanding contextualized functional analysis driven assessment.

Note: You won’t have to go read Big Purple to use this system. We’re planning to present relations in pretty visual analytics that even clients can make sense of. We’d like to make explaining relationships (between verbal behavior and verbal behavior or verbal behavior and EMA/EMI passive behavioral data ) functional. Wouldn’t it be nice if you could such demonstrate your outcomes in forms that show you make ‘real’ change in the lives of your clients?

See previous post on RFT: Relational Frame Theory (RFT)- What’s the big deal? And, Hayes & Berens (2004) Why Relational Frame Theory alters the relationship between basic and applied behavioral psychology for why RFT is important to this. If, your mind just squealed… “but relating and frames are just constructs!” See future post on empirical logic and the difference between reifying constructs and properties.

Essentially, we need to add in RFT because we know that verbal/symbolic relations can more powerfully influence behavior in the moment than the actual contingencies. Additionally, integrating RFT allows us to step back and forth from behavior, to intervention, to level of appropriate measurement across diagnoses and therapy orientation – so maximum flexibility and applicability.

I understand that many of you may be thinking at the point… so, are we talking assessing the content of language? Word counts? 

Well, no and yes… we do look at the verbal content but we can look at functional relations indicated between verbal relating and verbal relating, or between this and other behavioral measures. I’ll save that for another post.

For now, here’s some ground work within CBS that supports the use of attempting to assess verbal/symbolic relating through language:

Atkins & Styles (2016). Measuring self and rules in what people say: Exploring whether self-discrimination predicts long-term well-being (ACBS membership needed to view).

Collins, Chawla…Marlatt (2009). Language-based measures of mindfulness: Initial validity and utility

If you’re interested in learning more about clinical behavior analysis, RFT, and advanced measurement methods – let us know in the comments below! We also have some online, on-demand training events on a variety of topics that may interest you.

RFT: The Space-time of the Human Universe, Part I

RFT: The Space-time of the Human Universe, Part I

Original post to angelacathey.com (June, 2016)

I’m going to start this post off by telling you a little secret. I get a little obsessive with ideas. Give me something interesting to think about and I’m a kid with a Rubik’s cube all over again. When I immersed myself in RFT I turned that Rubik’s cube so many times I dreamt in RFT. (Yes, I know that’s weird.)

While you’re adjusting to that information, let me show you why I will probably never get tired of playing with this toy. I’m going to show you several metaphorical, philosophical, and sometimes downright fun, ways to understand RFT. 

CONSTRUCTS, RELATIONS, AND THE BEAUTY OF THE UNIVERSE

First, let’s loosen your frames a bit and help you ‘connect’ more abstractly. Let’s channel Karl Sagan for a moment and teach RFT through a little astrophysics.

Imagine the earth and planets swirling about in space. They all have this rhythm and dance to how they move about each other. Imagine now that those planets are constructs (e.g., “psychological flexibility”, “courage”, “love”, “present-moment-focus”, “mindfulness”, “habituation”, “transference”, etc).

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Now looking out on the planets we are like the astronomers once were… seeing these celestial bodies in awe but not understanding their rhythms. We can ‘see’ them dancing around each other but we can’t tell why. Most of our scientific method in psychology is based around this level of mystery. We assume we know very little and that every hypothesis is a bit like glancing in the telescope and hoping we see planets crash together. If we see it, and we haven’t spent all day looking through the telescope… then that’s an important finding! And, because we can’t all watch the whole universe we each pick a few planets (constructs) to watch intensely.

Now let go of your favorite planets for a moment and zoom back… look at the big picture. See the planets moving on their orbits over the course of time…

Now drop to a different level of analysis.  In this picture, we see what we scientists later understood about planets influence each other.

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What we understood that gave us infinite and useful knowledge about space (even beyond the planets we could see) was… as Karl Sagan put it, “gravity is geometry.”

Gravity is a distortion in space-time that forms a kind of net that allows the weight of the planets to pull against each other. This is what gives them their lovely dances in relation to each other.

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RFT, and behavior analysis more broadly, is the gravity beneath our day-to-day behavior. It shows us how the constructs influenced by human verbal/symbolic behavior dance together.

This is ‘true’ in several ways:

Gravity is a very ‘real’ force to be reckoned with and yet you can’t ‘prove’ it in most contexts. We just trust that it’s there because it is useful to do so. The construct of gravity is a description of relation. It’s a useful explanation in daily life for why it would be stupid to hold the DSM-5 over your foot and drop it. Sure, you could go ask Karl Sagan for the formula and proof but in the meantime… you should probably still move your foot out of the way of the DSM.

In the same way, RFT relations can’t typically be ‘proven’ in the moment. That’s not the point in applied work though. Like the web you see below the planets, what RFT, and behavior analysis more broadly, gives us is far more powerful than a view of the actual planets. It gives a way to predict and intervene in nearly anything influenced by human thought. (If that doesn’t inspire awe … go back and read it again.)

Planets collide…

On another level, what it does is let use see the planets in a new light. They are no longer separate planets dancing unpredictably in space. They are a tiny visible piece of the universe dancing an understandable rhythm influenced by the interlocking distortion of space-time that holds them in relation to each other.

And just like this conception of gravity as space-time distortion… understanding RFT, and behavior analysis, allows us to come up with some amazing ways of understanding our universe.

If you like learning about Relational Frame Theory, behavior analysis, principles, or the philosophy of science through metaphor, or otherwise, let us know in the comments below! 

The Power of Choice

The Power of Choice

‘by Angela Cathey, MA, LPC

Recently, we had the good fortune of having Benji Schoendorff, MA, MSc for an interview. Benji is a renowned Acceptance and Commitment trainer. He is a joint owner of the Contextual Psychology Institute (CPI) with his wife Marie-France Bolduc. They and their beloved son travel the world doing their part to put ‘psychological flexibility in the water supply.’ Benji is a deeply principle-driven clinician and trainer. His work is highly informed by Relational Frame Theory (RFT) and behavior analysis. In addition to the training that Benji does to increase the skill of individuals, Benji and the Contextual Psychology Institute (CPI) also work to improve contexts by training organizations to better engage with the ‘difficult’ in the service of reaching their goals and values.

Below, we discuss some of Benji’s recent work and thoughts on applying ACT to organizations.  

Angela: “Benji, you’re a celebrated trainer of ACT and FAP. You travel the world teaching others to be more aware, mindful, and courageous in how they work with each other. Though you’ve had a great deal of impact on many in psychology, by teaching evidence-based interventions, your work has ventured more and more into changing larger contexts as well. Can you tell me a bit about this focus and how it has brought you further into consulting?”

Benji: “My personal mission, and that of our institute, is to slip psychological flexibility in the water supply. What I mean by ‘psychological flexibility’ is the ability to choose to do what matters, even in the presence of obstacles. It is about choice. Individuals who are ‘stuck’ feel they don’t have a choice, and the same is true of teams and organizations—and of course of individuals within teams and organizations. We all know that businesses and organizations are sitting atop a hard to tap gold mine: employee engagement. I believe being able to choose to do what matters in your professional life just as much as in your personal life is the key to both well-being and to fully engaging in our lives and work. After all, we spend a good chunk of our waking life working. Yet paradoxically, our present organizational structures largely deprive us of choice. Is it a wonder that employees aren’t as engaged as they could be? What we’ve discovered is that using the applied principles of modern behavioral science, there is an easy and intuitive way to increase ‘psychological flexibility’ in the workplace and in organizations. It’s a simple and intuitive model we call The ACT Matrix and I believe it has the potential to revolutionize our working lives as much as our personal lives.”

Angela: “That’s wonderful Benji. For those who haven’t met you, can perhaps tell us a bit more of what is it like to work with you personally in personal or organizational psychological flexibility initiatives?”

Benji: “In the spirit of 360-degree feedback, I’d invite you to ask my team members and past clients. I think they would say that I am creative, passionate, values-driven, flexible, fun to work with and always human. My working style is highly participatory and I love to make work fun! I seek to create contexts in which people can best contact their resources and make their own best choices. I believe every person can make their own choices and I know how to inspire folks to feel that way. As a leader, I trust my team members to make decisions, preferring to advise than dictate. As a consultant, I connect with my clients’ unique needs and perspectives to help them identify original and above all workable ways to reach their goals.”

Angela: “I see the flexibility and awareness in the way you pursue life itself. It takes a deep commitment to innovation and humanity to truly walk the path you espouse so fully. I’m excited to be working with your team more closely these days and enjoying the development of technology and change with you. Can you tell us what your strengths and ‘learning edges’ are?”

Benji: “The learning edge feels tricky… I have many learning edges. The one I am working on at the moment is to further develop my ability to integrate the technology you are developing into my consulting work to help clients track how effective working with The ACT Matrix can be to foster team and individual productivity and empowerment. I am also working on being more compassionate and validating, more consistent in my work, more responsive.”

Angela: “Those are certainly worthwhile goals and lately, it seems like you’re all over the world putting these into place while doing workshops? How do you see this work developing as you put ‘psychological flexibility into the water’ so to speak?”

Benji: “Well, I am trying to write a lot of blogs and of course I give lots of trainings, nearly one a week, and we are getting more trainers to work with our institute, though that’s barely started.”

Angela: “That’s wonderful! I am looking forward to seeing more from you and CPI. Tell me, is there a leader, idea, or experience that has most influenced you on your path?”

Benji: “The person that has most influenced me in my work is without question Steven Hayes, the main founder of Acceptance and Commitment Therapy or Training (ACT). Steve is an absolute trailblazer, and the sweetest human being, combining the sharpest intellect and a deeply human heart. His stroke of genius was to see that human suffering and getting stuck are not ‘pathological’ processes, but an inevitable byproduct of how our minds work. He set about to understand what processes could account for the difficulties we experience and what to do so we can more easily get unstuck and do what’s important to us. That makes ACT translatable to the world of business and organizations. In my organizational work, I am so grateful to Kevin Polk and colleagues who developed The ACT Matrix, a simple and intuitive way to bring the power of Acceptance and Commitment Training (ACT) to the world of business.”

“Finally, I want to mention Dennis Bakke’s books, ‘The Decision Maker’ and ‘Joy at Work’. Bakke built a 47,000-strong multinational Electricity-generation company by radically devolving decision-making to his employees. His core idea is that if we treat people as fully responsible adults in the workplace by letting them make all the decisions that concern them, they will fully engage in their work. For Bakke as for me, this doesn’t just make perfect business sense, it is a core value for the full realization of our human potential.”

Angela: “Interesting. There’s been a great deal developing across fields that I believe will change the face of our workplaces in the future. As our lives have become more connected by technology, I believe we’ve become more disconnected in our lives. Workplaces offer these wonderful microcosms of our lives and networks, both socially and technologically. In an era of constant movement and short job tenure, the characters in our lives are ever-changing, connected-but-not… our lives and well-being increasingly seem tied to our ability to co-exist productively, sustainably, and cooperatively with others who may not know us or understand us. This is both exciting and terrifying. We have the chance to grow as a species, but will we choose to? I believe that if there are people like you, who choose to walk the more challenging paths, we may have a chance. Thank you so much for your time, Benji. I look forward to seeing more and more of your work and deepening the ties between our organizations.”

 

Relational Frame Theory (RFT)- What’s the big deal?

Relational Frame Theory (RFT)- What’s the big deal?

by Angela Cathey, MA (Original post to angela.cathey.com June, 2016)


So, what’s the deal with RFT? Isn’t this just another theory to add to your dusty reading stack? No. Put it on top, like yesterday.

RFT is a theory of how relating becomes a part of our processing of the world. We are richly hooked into our very verbal sense-making of the world. Our internal verbal-ish history can become a more predominate shaper of perception, in the moment, than even previous respondent or operant conditioning. Move over Bandura and those ridiculous Bobo dolls, we’re onto something big.

Yes, it’s a big deal. HUGE. The most coherent, expansive, and useful theories we have in psychology allow us to predict and influence behavior are operant and respondent conditioning-based. Functional Analysis (FA) is a cornerstone of modern behaviorist therapies and yet we’re saying that even if you account for all the ‘external’ context you could be missing the most important variable in the room.

Our ideographic and collective history of verbal relating influences our perception. Note: this is not the same as ‘language’. What we’re talking about is a hodgepodge mix of learning history, language, internal rules, sensations, etc. that people often hear as “language”). It’s not about “language” it’s about relational history that gets heavily influenced by language because that’s the framework we see the world through. Just think… when is the last time that voice in your head actually shut up? Never? We are verbal and that verbal-ness is often key in high-jacking a human’s response to the contingencies in the room. Further, we understand that the specific ways and frequencies in which we relate things can influence our perception, behavior, emotion in predictable ways.

So, this verbal relational soup of history is on-going and heavily influencing our contact with the world. This is pretty profound, but in itself, esoteric at best. Like knowledge of quantum mechanics and M-theory it’s cool but what can we DO with it? That’s where we really start getting to the sexiness inherent in RFT. RFT describes properties of relating such that you can walk back and forth with empirical logic from observation, to assessment, to intervention strategy.

As a clinician and researcher, I’ve done most of my work in exposure-based treatment of anxiety and related issues. In treating severe anxiety at the Intensive Outpatient and Partial Hospitalization levels I saw clients on a daily basis for hours, for months at a time.  It was doing this level of treatment where I saw the quirks of change, or lack of it, in my client’s behavior the best. It was here that I kept running across quirks in treatment and assessment that were not well explained in the literature. One of those phenomena was that what tended to most amp up or dampen exposure intensity within OCD and PTSD wasn’t what you’d expect. I found that often the stimuli or experiences that were most painful for people were linked to their values or their sense of themselves, others, or the world. I also noticed that sometimes hierarchies needed to include exposure to stimuli that just didn’t fit into normal models of fear conditioning (see exposures to milkshakes, umbrellas, The Doors, and emotions themselves). And, weirder yet – that a change in context could sometimes seemingly result in immediate ‘habituation’.

I returned to Relational Frame Theory and behavior analysis because training across modalities still left me with insufficient explanation for what I saw. Take the example of values intensifying exposure via values. Yes, that might be covered by ACT mid-level terms but it doesn’t give you a full picture. If we consider properties inherent in various types of ‘framing’ that might be at hand in values we not only know what to do to move this material with the client but we also have indications of other, less intuitive things that might also be amply or de-amplify an exposure (outside of values). We can reasonably say that hierarchical framing is likely at hand. Knowing this, we might also be able to find other material that moves exposures up and down the hierarchy simply by understanding the types of relations that are most predominant in driving the client’s experience. 

What’s more, you can do this underneath the level of therapeutic orientation and diagnosis. Everything becomes about relations that we can influence without clinging to our own preferred tools. (Yes, that’s right. I’m a behaviorist and I believe those psychoanalytic folks may even be getting it right too – just differently. None of us has a total lock-down on effective treatment.

I see this as the real beauty and possibility of Relational Frame Theory and behavior analysis – the promise that unification of psychology – across all areas influenced by human thought, across levels of analysis, across basic and applied, across therapeutic orientation, and across diagnoses might be possible. That we may just be able to move forward from the elaborated mess of opposing theories, big egos, and lack of cooperation that we currently call ‘psychology.’

Are you interested in learning more about RFT and behavior analysis? Let us know in the comments or consider taking one of our online training events.

 

What is Acceptance and Commitment Therapy?

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy or “ACT” said as one word is considered one of a new wave of cognitive-behavioral therapies, including Dialectical Behavioral Therapy (DBT), Functional Analytic Psychotherapy (FAP), and others. These treatments largely involve many of the aspects common in traditional cognitive-behavioral therapies but with important technical and theoretical differences (Hayes, Strosahl, & Wilson, 1999). In ACT there is a focus on “accepting” what is out of the client’s control and commit to changing what is in their control, to improve their lives (Orsillo & Roemer, 2005). ACT includes the use of mindfulness, to assist in reaching these goals, which has long been a part of Eastern philosophies such as Buddhism and Taoism. Mindfulness can be explained as being aware of your experiences moment to moment and experiencing them with openness and interest, rather than judgment (Hayes et al., 1999; Orsillo & Roemer, 2005).

ACT is a tradition based on Functional Contextualism (Hayes et al., 1999). Functional contextualism is a form of pragmatism, which states events should be understood as a whole, in context, and as ongoing (Hayes et al., 1999). This is in opposition with most traditional views of behavioral therapies, which are more present-focused and tend to limit their focus to what is appears directly relevant to the presenting problem. Also important in functional contextualism is the following of pragmatic truth criterion. Pragmatic truth criterion refers to judge the effectiveness of our actions based on how they meet our goals rather than their match to some supposed concrete reality. In this line of thought, no ‘truth’ is universal; what is true is only what works in getting a person to their unique goals. This differs from most traditional cognitive-behavioral treatments that might focus on having clients test the validity of their thoughts in quasi scientific manner against reality. In ACT, a person we would tend not to ask a client to test their thoughts regarding fears to see if they are “valid” or “logical” fears. In ACT, the focus is on whether believing the thought constricts or expands the individual’s ability to live a valued life. This is often referred to as “workability” and is a central concept to contextualism. “Context” here refers to how the behavior occurs and what rules govern the behavior (Hayes et al., 1999). Within ACT the context of the behavior, and not the form, of the behavior itself is the focus of change. Thus, symptom reduction is not directly an aim of ACT but rather a side effect (Hayes et al., 1999). From the ACT perspective, suffering is both a necessary and unavoidable part of life, but the way we experience suffering is determined by our understanding of it (Hayes et al., 1999).

Also essential to the foundation of Acceptance and Commitment Therapy is its take on the role of human language in human suffering. Understood through Relational Frame Theory, human language as a process results in destruction, dysfunction, and pathological processes (Hayes et al., 1999). Language is necessary for the advancement of human society and each individual, however; the associations we make through language eventually cause us misery. Relational Frame Theory (RFT) suggests that through behavioral conditioning language itself can affect how we feel. As we learn language, conditioning creates “mutual entailment” or bi-directionality in associations between words, feelings, and things. It is in this way that children learn that words and things are equivalent (Hayes et al., 1999). However, it is his essential feature in learning to communicate with others that can later cause us a great deal of suffering. Since the words we have learned trigger the images and feelings they have been paired with in our past; we are prone to sometimes feel emotional pain unnecessarily. Just as when you think of the word “lemon”, you have an immediate reaction to taste sour you can have a response to the word “anxiety”, such that thinking about the word “anxiety” can make you feel anxious. This creates problems because as most people try to avoid feeling unpleasant feelings; they cause themselves the very feelings they are trying to avoid. For example, to think, “Don’t get anxious!” includes the thought of “anxiety”, and thus feelings of anxiety (Hayes et al., 1999; Orsillo & Roemer, 2005). These conditioned relationships in our minds are the result of often life long patterns of association, and thus are also quite difficult associations to break up. And, in fact, though we can break them up they quite often resurge (Hayes et al., 1999).

Through ACT individuals learn to reduce the impact of conditioned language associations on their feelings and actions. ACT takes the position that because of the way we process language, according to RFT, our typical methods for solving problems logically in the outside world are inappropriate for solving problems with thoughts and feelings. We tend to assume that we must simply determine the reason for some unpleasant feeling or behavior and remove it, to remedy unpleasant feelings or consequences. This leads us to the culturally supported idea that thoughts and feelings are good explanations for what we do. So, though we have the capability to act contrary to our thoughts and feelings, we assume that to control our actions we must control the feelings and thoughts associated with them. However, as RFT indicates, the more we endeavor to control our thoughts the more we will suffer from them. Therefore an important feature of ACT is to reduce experiential avoidance, or the unwillingness to experience certain feelings (Hayes et al., 1999; Orsillo & Roemer, 2005). What we have to realize is that it is perfectly normal to feel unpleasant feelings at times and that the objective to control, reduce, or rid ourselves of these feelings is not a successful approach (Hayes et al., 1999).

ACT suggests that the alternative to experiential avoidance is acceptance, and mindfulness, as in accepting that feeling unpleasant sometimes is a natural and necessary part of life. ACT also suggests that choice and committed action are more appropriate ways to deal with life than avoidance. ACT’s goals include the shift from understanding words as content to context; learning to understand both the benefits of language and how it can affect us negatively when we do not take into account the learning context (Hayes et al., 1999).  ACT seeks to undermine unworkable change agendas, such as experiential avoidance, by helping clients realize their refusal to feel and accept causes more pain. In addition, ACT seeks to help individuals identify and clarify their life direction and goals. ACT therapists endeavor to suspend their own judgment regarding what goals a person should have, because from the ACT perspective, the appropriateness of goals is subjective, and the client should pursue those goals important to them (Hayes et al., 1999).

Therapeutic tools used in ACT, to reach ACT consistent goals, include: the use of metaphors, therapeutic paradox, and experiential exercises (Hayes et al., 1999). Metaphors are used to reduce the impact of literal language and to prevent the client from simply following the requests of the therapist without achieving true understanding. Since metaphors cannot be exactly interpreted, they cannot be exactly followed; the client is forced to experience and understand rather than rely on the therapist’s direction (Hayes et al., 1999). Therapeutic paradox is similarly used to reduce the impact of literal language on the client. The client is given a task where they can experience the consequences of not avoiding their symptoms, which typically includes a reduction in the symptom. Experiential Exercises can also be used to change the verbal context of situations, so that the client can learn to observe and study their feelings without imposing judgment on them. ACT methods include many metaphors and experiential exercises to address different problems and different frames of mind. Another tool used by ACT therapists is creating “hopelessness” in clients by pointing out the failure of previously used methods to control their feelings. This technique motivates the client to accept new ways of understanding their problems and new solutions for them (Hayes et al., 1999). As mentioned above, ACT therapists help clients explore their values and help them learn to lead their lives in accordance with these values. This last phase of treatment is often more behaviorally oriented than other phases of ACT; it includes intense discussion over the client’s values and behavioral strategies to assist the client in reducing discrepancies between their actions and values (Hayes et al., 1999).

Recent years have seen an explosion in ACT-related research and the effectiveness of ACT in many different populations and with many different diagnoses. Hayes and associates continue to conduct training seminars, workshops, and conferences devoted to the promotion and further development of ACT theory and methods. Clinicians also continue to develop a wider variety of useful metaphors and experiential exercises to inspire clients to a new understanding of their problems and motivate them to “ACT” in line with their values (Hayes et al., 1999).

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