The Initial Session: Setting Up the ACT Matrix For the First Time
Setting yourself up for success
I firmly believe the initial session with a client is the most important moment in the therapeutic process. This is the moment a relationship begins. It’s also often the moment a relationship ends. The most common number of sessions a client attends is one. This initial session is the space where your clients choose to begin a process of change in earnest, or decide that it’s not worth the effort. The importance of this session demands that everything be done to allow success for you and your clients. The ACT matrix has changed how I do therapy forever, and it all begins during this initial contact.
Setting yourself up for success means finding a rhythm that works for you in your intake sessions, understanding where clients are coming from, and creating an environment that is welcoming and hopeful. This chapter will cover the methods that I have found to be most effective for setting up the kind of work I do. Again, and again, the ACT matrix has served to foster these crucial elements. After reading this chapter you will be able to implement these methods for yourself in entirety, or pick and choose which will work best for you. Either way I encourage you to experiment and be flexible with your thinking.
For more great information on the importance of the initial session, and the value of doing brief work I highly recommend Brief Interventions for Radical Change by Strosahl, Robinson, and Gustavsson. https://www.newharbinger.com/brief-interventions-radical-change
Previewing what’s to come
When clients present to therapy for the first time we need to keep in mind where they are coming from in terms of their experiences of therapy. Many clients are embarking on this journey for the first time, which means that their only frame of reference for what therapy is and what it entails is what they’ve seen on TV and in movies, and from experiences with other healthcare professionals like doctors and physical therapists. As the clinicians we are familiar with the process, and meet with clients so often that we can fail to recall that the person sitting in front of us may have no idea what to do next. Shifting into the perspective of a client who has never set foot in a therapists office is helpful in guiding the first moments of contact with a client. I work in a private practice which allows me a certain freedom in how I begin with clients, nevertheless I think my approach can be of use for clinicians in any setting. The following is a spiel that I have memorized and use with every client as a part of the very first thing I say to them after greeting them and escorting them from the waiting area to my office.
“Nice to meet you, again my name is Jacob and I’m one of the counselors here. I just went through your paperwork and everything looks great, thank you for filling that out for me. Typically what I do when I meet with someone for the first time is three main things. First we’ll get a chance to talk more about what brings you here, what you’ve been experiencing in your life and how it’s been affecting you. Then at a certain point in our conversation we’ll shift into sorting out what we’ve been talking about into a kind of framework, or system, that I use. It’s mostly for me, but it’ll help us focus our work together moving forward, and sometimes my clients find it very useful in their own lives. Then the last thing we’ll do is take care of odds and ends, like scheduling, talking about what our next sessions might look like, answering any questions you might have, stuff like that. Does that sound good to you?”
I’ve said this spiel so many times that I can say it in my sleep, and not once has a client disagreed and said “No I want to do this first session differently!” This spiel is vitally important for me in setting up what the first session looks like, but also therapy more broadly. What I’m doing is previewing what is going to happen just minutes from now. I’m also letting the client know that I am the one thinking about the pace of the session and keeping a general track of time. In this spiel I also foreshadow the matrix as a tool that we will use together for our mutual benefit. Right off the bat the client now knows that we will be talking about what brings them in, working together in some way with that content, and then looking ahead to the following sessions.
Notice how I refer to the matrix as “a framework, or system” rather than by name. In truth, none of my clients know the matrix as “the matrix”. When I introduce it to them and in any future sessions I simply call it “our toward and away system”. There’s nothing wrong with calling it the matrix, I simply never have with clients.
After this spiel I ask clients to help me understand what brings them to see me, and from there the work begins. As clients speak I am mostly listening and assessing for certain things. Essentially we are letting our clients tell their story. This is where your unique style will come into play. I use a fairly brief functional contextual interview style to gain more information. If you have certain assessments that you prefer to use during the initial session feel free to continue to do so. The only thing to keep in mind with using the ACT matrix as a part of your intake session is that at minimum you want to reserve thirty minutes for setting up and walking through the matrix for the first time. If you are unable to fit these thirty minutes into your typical intake session then I would suggest saving the matrix for the second session. It was only after practicing the matrix several times with clients that I found a pace that works for me. The process of doing a matrix with clients is an act of history taking and evidence gathering, and much of it will likely overlap with questions you are already asking during intake, so once you are familiar with the matrix you’ll be able to see where it best fits into your way of working.
Sorting it out
At a certain point during the history taking process you’ll feel ready to shift into introducing the matrix to the client for the first time. The timing of this is dependent on the context, and will differ from client to client. I typically shift into the matrix once I feel I have a good enough sense of what they are going through and why they have chosen to begin therapy at this time. I tend to take shorter client histories than most therapists I know, but what I do works for me. While walking clients through the matrix you can always ask more questions and follow up with anything you’d like.
Initiating the shift to the matrix is as simple as saying to the client, “I think this would be a good time to start sorting what we’ve been talking about into that framework I mentioned earlier.” At this point I have clipboards and blank sheets of paper at the ready to hand to my client. For the first time the client sees the matrix I prefer to use a blank sheet where the client can draw the entirety of the matrix from scratch rather than use a matrix template. I want the client to feel as though we are working together on something from beginning to end, rather than like I am asking them to fill out a worksheet. I also prefer using paper and pen rather than a whiteboard and marker for this initial matrix so that the client can take theirs home when they finish, and so I can make additional notes on my matrix as needed. There are also a few elements of introducing the concept of the matrix that having it on paper allows me to do more easily.
Face the client with your blank sheet of paper on a clipboard on your lap. The following is my next spiel to introduce what we are about to do together:
“We’re going to be doing a kind of diagram together, it’s super simple, you don’t need any art skills or anything like that. I do mine landscape style, like this (turn clipboard sideways). Just follow along with me. First we’re going to use an example to help us set this up, once we’re finished with the example we’ll put your life and the things we’ve been talking about into it. Okay?”
Every client that I have ever worked with has been okay with this. When I train clinicians on the matrix I sometimes hear things like “I have clients who would never do this,” when I follow up they are often referring to teenage clients or mandated clients. I have and do work with both teens and mandated clients frequently, and none of them have ever been opposed to doing this. I attribute this to setting it up in session one upfront, and relying on building good rapport with the client during the history taking portion. Keep an open mind when introducing the matrix to clients, if they don’t want to do it let them tell you, don’t assume for them that they won’t want to do it.
From here, I ask the clients to draw a straight line across the middle of the page with an arrow on each end. I draw the arrow as I am asking them to do so. A benefit of using a handheld clipboard is that I am able to draw what I need to and then flip the clipboard outward so that the client can see it. The majority of the time I have the clipboard facing the client so that they can follow along with me.
“The first thing I want you to do is draw a straight line across the middle of the page like this, with an arrow on each end of it.”
Once the client has drawn their arrow, I then say, “Great, now on one end of the arrow right the letter T, and on the other write the letter A.
Be sure to place the letter T on the right hand side of the arrow, and the letter A on the left hand side. Once the client has this on their page I state that the letter T stands for the word toward, “Like moving toward something,” and the letter A stands for the word away, “Like moving away from something.”
Next I have a spiel that sets up the concept of toward and away using a metaphor a rabbit. This metaphor is similar to the one used in the book The Essential Guide to the ACT Matrix, by Polk, Schoendorff, Webster, and Olaz. While the metaphor is similar, I have created a consistent spiel, or way of presenting it that helps clients understand some important concepts that will be useful later on in the work. The following is my rabbit metaphor spiel in it’s entirety:
“Ok so if you've got that, I want you to imagine a rabbit. Like a bunny rabbit that you'd see outside. If you can imagine a rabbit, you can probably also imagine that there are things that a rabbit would like to move toward or get closer to, and things a rabbit would like to move away from. What is something a rabbit might want to move toward?”
Client: Food? Carrots?
“Yeah, exactly. And what about away? What is something a rabbit might want to move away from?”
Client: Predators. A fox.
“Yep. Pretty easy concept, nothing difficult about that. But this is actually a three-dimensional concept.
[At this point I take the paper off of the clipboard and hold it in my hands facing the client]
You see, you can imagine a rabbit moving away from a fox and toward a carrot at the same time.
[I bend the paper into the form of a cylinder such that the toward and away sides of the arrows touch each other]
So it doesn’t have to be one or the other, it can be both depending on the situation. Well it turns out that human beings like me and you and everybody else in the whole world, we’re a lot like rabbits. We move toward and away from things too, sometimes it’s literally carrots, and literally predators.
The only main difference between us and rabbits is that we have a slightly bigger brain than rabbits do. That extra brain space, comes with what I like to think of as almost two different worlds that we have to live in. Here’s what I mean by that, rabbits mainly have an outside, physical world that they live in. They care about actual carrots they can eat, and real predators they can run away from. If you took your phone out and showed a picture of a carrot to a rabbit it might not care about that at all. It’s not real to it. If you showed a video of a fox to a rabbit it might run away for a second, but once it realizes it's not real it’s fine again.
But you and I can see a picture, or watch a video, or get a text message and we can kind of get hung up on it all day long. . . or a week later we can still be thinking about it. . . or twenty years later we can still be thinking and affected by it.
That’s because just like rabbits we have this physical, external world that we live in, and we also have an internal world which is all of our thoughts, feelings, memories, and things like that, that we live in. Our inner world and outer world influence one another and we have to learn how to navigate that. This will come into play later on in our diagram, for now, let’s continue. . .”
After this spiel I ask clients to draw a straight line down the middle of the page vertically, creating four boxes.
Now it’s time to introduce your client to the four questions.
“So now we have four boxes. I’m going to ask you four questions, one for each box, and what I want you to do is jot down your answers in the boxes. You don’t have to write complete sentences you can just make a bullet list. And I’m not going to read your paper, you’ll read it to me, so don’t worry about your handwriting or anything like that, okay?”
Client: Sounds good.
Start in the bottom right hand square (be sure that this is the toward side for your client, every once in a while clients will reverse the toward and away sides).
First Question: “Who and what are important to you?”
“This can include anything at all. People, places, things, things that aren’t physical, like qualities, or concepts, it’s all fair game. Anything that’s important to you, go ahead and write it in this box, and let me know when you’re finished.”
Allow the client some time to think and write. Some clients can come up with these answers very quickly, others will take a bit of time. During this process take care not to stare them down as they are writing. I often use this time to jot down notes into their file. The client will let you know when they are finished. Once they are, ask the client to read to you what they wrote. As they read it out to you write down their answers on your matrix. It’s okay if clients only have 2–3 items on their list, this is common. In my experience the least common number of answers is one. You will often see the obvious answers as the first few on a person’s list, family, friends, etc. If the client has written more than just a couple these tend to be qualities like honesty, being happy, and stability.
As clients read out their items make no judgments about them. Simply write them down as they have, and once finished thank them.
In traditional ACT work attention is paid to identifying, clarifying, and connecting to values. What is and what isn’t a value is often subject to confusion by therapists and clients. When it comes to the ACT matrix, we are not as concerned with the nature of values vs. goals, or how shallow or deep values are. The primary target is just who and what make life meaningful, and how. This first step of asking who and what are important to them is exactly that, a first step. It is not meant to be the beginning and end of the values discussion. Items written in this first quadrant may be goals, values, wants, needs, or all kinds of other things. Attempting to categorize or define them is not important. Broader values and committed action work will occur throughout the therapeutic process.
Once clients have shared their entire list with you, let them know that no matter how simple their lists look they are actually very complex. For example, yes family and friends are important to us, but not just their physical presence is important, how we are with our friends, and the kinds of relationship between us is important. If a client writes something like “being happy”, probe them for more information about what their definition of happiness looks like, what it doesn’t look like, what kinds of actions, places, or situations have sparked happiness for them.
Probe and break down each of the items on the list. During this conversation you can ask as many follow up or clarification questions as you like. After going through all of the items then move over to the lower left quadrant.
Second Question: “What are some of the things on the inside, like thoughts, feelings, memories, etc., that can show up to get in the way of these people and things that are important to you?”
Allow space and time for clients to write this list in the same way as before. When they let you know that they are finished, ask them to tell you their list and write it down on your end. Ask any follow up or clarifications as you might need to get a better understanding about what they’ve listed.
You may be surprised at what clients write in this box. Sometimes the content is wildly different than the things the client was discussing as problems in their lives during the history taking portion of the session. A client I once worked with who had a severe case of OCD discussed their symptoms in detail during the history taking process, but when it came to the inner stuff that shows up to get in the way the main content in the box were thoughts and feelings related to pushing his friends away, struggling with what is morally right or wrong according to his faith, and sticky self-criticisms. It wasn’t long before we linked these feelings and thoughts to an amplification in his OCD symptoms.
At the same time, make sure that clients are not ignoring certain content they discussed during the history taking portion. If a client discussed major depressive symptoms that keep him in bed all day more often than not yet his lower left hand square has only a couple of superficial elements, ask the client if what you’ve discussed earlier gets in the way at all of who and what are important to him. Following up in this way will lead either to more items added in the lower left hand quadrant or a re-evaluation of the items that he reported being meaningful to him.
I often ask clients to denote thoughts that show up by putting them inside quotation marks. Doing this is an initial step toward transforming the stimulus function of the cognitive content.
Now it’s time to move to the upper left quadrant. Before I ask the question for this quadrant I let the client know that we are going to link some of the elements in the bottom left quadrant up to the top, as I say this I draw an arrow arcing from the bottom to the top.
Third Question: “What do you tend to do on the outside, in terms of actions, when you are wrapped up by the stuff on the inside.”
In the upper left quadrant we are aiming for actions, encourage clients to write how they typically respond when under the influence of the items in the lower left. Clients rarely have difficulty with this portion. Every once in a while clients will ask you something like “Do you mean like what coping skills I use?” We do not necessarily want clients to only list their coping skills here, what we want is how they tend to respond to the inner stuff, whether that’s by way of coping skills they’ve learned in the past, or any other behavior or action. Automatic reactions like “crying”, or “having a panic attack”, can also be listed in this quadrant.
In the top box pay attention to the sheer number of clients who list “push people away”, “isolate”, “shut down”, or similar, no matter what their presenting issue is. Some form of pushing people away is easily the most common item I have seen in my work with clients. Think about this. What does that tell you about the real pain points people experience?
Move through this list in the same way as with the others, asking questions to help put these actions in context. Once you have finished, draw another curved arrow from the top box down to the bottom, and ask the client what shows up on the inside of them after they do/engage in the actions listed in the top box.
Clients will almost always state that more of the same inner stuff shows up, or new uncomfortable inner experiences such as guilt, shame, anger. Process out any new items listed, and then point out the arrows that you’ve drawn.
“Do you see the way I’m drawing these arrows here?”
Client: Yeah, I do. [Chuckling]
“Does this look familiar to you?”
Client: Yes, it’s my life. A vicious cycle.
“This is actually a very natural human thing, it’s what we call a loop, or a stuck loop. We have thoughts and feelings that show up on the inside, we respond to those in some way on the outside, and then have more stuff show up on the inside. Sometimes this can create a kind of feedback loop. Guess what? Rabbits don’t do this. This is proof that you’re a human being, so congratulations! Every human being gets caught up in a stuck loop from time to time, there’s actually nothing wrong with it at all, it only becomes a problem when we get so stuck that we can’t get out. We’ll come back to this idea in a bit, why don’t we finish our last box up here and then we’ll round it out.”
Now it’s time to finish the final box.
Fourth Question: “What are some things you can actually do that would move you toward who and what matters to you?”
Repeat the process of allowing space for clients to write, sharing their list, and following up with questions. All four boxes of the matrix should now be complete.
In this upper right hand box clients may struggle to identify meaningful actions they can take to move toward what matters to them. At this stage in the the work you’ll likely see superficial items in this space. This is okay, because a large part of the therapeutic process is about identifying and engaging in these actions.
Setting goals for working together
Now that you have the four quadrants of the matrix completed it’s time to round out the tool and start to use it to enhance your practice. The first step is to start setting goals and to form a contract about what therapy is going to look like with you.
Present the completed matrix facing outward to your client, and ask to think about the past months/weeks/years of their lives. Ask them which side of the matrix they’ve been living on the majority of this time, the right hand side or the left hand side? More often than not they’ll state that they have been living on the left hand side, or the away side. Let them know that this is not surprising given the loop that they identified earlier. Other times clients will state that they have been flipping back and forth between the away side and the toward side.
Every so often a client will state that they have been living mostly on the toward side, when this happens it’s an indication that somewhere along the process of the matrix you have not gone slowly enough to identify the presenting problem, or that there are things the client has not shared with you. Now is the time to look back at the squares and really try to work with your client as to why they are here if nothing seems to be getting in their way. Do this before moving on to the next step.
Here is where I set the main goal of therapy, or the contract of working together with my client using the following spiel.
“Let’s say that you and I could work together here in this room every so often, let’s say once a week. If we were to do that, would it be okay if we made our goal of working together to be learning new and different ways of responding to this stuff down here when it shows up[point to lower left quadrant], while at the same time finding ways to move in this direction here? [Draw line up toward upper right quadrant]”
Client: Yes!
“Awesome, I think we can do that. So right now, you and I are setting up this goal that every time we meet we’re going to be laser focused on learning new and different ways of responding to this stuff down here, while at the same time finding ways of moving toward what matters to you.”
Pointing and drawing on the matrix while you do this creates a sense of real movement. We’re basically saying to our clients that we’re going to be headed somewhere very special, and that this tool is going to guide us there. No client in the history of my work since beginning using the matrix has ever said no to this proposition. It is instantly appealing to clients. After having set goals it’s your turn as the therapist to help explain how you are going to get there.
“We’re going to use this toward and away system as a kind of map to help us get to where we want to go. It will be helpful in a few different ways. Let’s start to talk about how it can help you. The first way it’s going to help is by setting up the language of ‘toward and away’. I want you to keep this in mind, this is a toward and away system, it’s not a good vs. bad, or right vs. wrong, system. It’s simply toward and away.
Let’s go back to our rabbit to help us out with this. What would happen to a rabbit that only ever moved toward carrots but never moved away from foxes?”
Client: It would get eaten.
“That’s right. And what would happen to a rabbit that only ever moved away from danger, but it never moved toward food?”
Client: It would be constantly running. It would starve.
“Yes. You see how too much of each extreme can be harmful?”
Client: Yeah, you’re right.”
“So we aren’t trying to turn you into some kind of perfect toward machine. We have to be able to do both. Anything up here in this top left box we’ll call an ‘away move’, and anything up here in the top right we’ll call a ‘toward move’. Toward moves move us toward what matters to us. Away moves are designed primarily to move us away from something that is uncomfortable to feel or unwanted.
You see these away moves you’ve listed are not negative, they just seem to not actually be doing what they say they are going to do.”
Client: You’re right.
“In fact, these away moves may unintentionally be moving you away from this stuff over here [points to lower right hand box]. So part of our work together is going to be identifying away moves that might actually work to also move you toward what matters. Remember, our rabbit can run away from a fox and toward a carrot at the same time.
Another part of our work is going to be finding more of these toward moves we can make that will help move you toward what matters to you.”
Client: Yeah, that makes sense.
“There will be times when I ask you to try certain things out outside of this room, for obvious reasons. If all we ever do is talk about stuff in here and never do anything differently out there, nothing is ever going to change out there.”
Client: Yeah.
“And this will help us stay on track during our sessions. I’ll stay on top of that. There may be times when I interrupt you or ask you to slow down and say something like ‘You know what, I feel like the last 10 minutes here hasn’t been moving us in any direction. Why don’t we look back at the reasons why we’re here and see if we can get back on track?’”
Client: Sounds good.
“And, what would happen if every time we came in to this room, we sat down and all we ever did was talk about this stuff down here, and we never talked about anything else? [Point to the lower left box and cover up the rest of the boxes with your hands]”
Client: I’d always just be thinking about it. It would probably make it worse.
“That’s right. So we’re not going to do that. Your life is bigger than just this box. You’ve got people and things that you care about, and we need to use all of it to help us get where we want to go.”
This move of pointing to the lower left quadrant and covering up the rest is the number one reason I prefer to do the initial matrix on a standard sheet of paper rather than on a big board. 100% of the people I’ve asked this question reply in the same way. Matrix work is about changing the way people think about therapy. Nobody actually wants to sit down and drone on and on about their problems, and everybody understands that doing so would be counterproductive. Highlighting it in this way up front allows you to side-step clients verbally dumping everything that’s happened this week onto you.
This spiel has covered several different ways you and your client will use the matrix to work together, it’s also given them an idea of what therapy is going to look like with you so that they can make an informed choice of whether to continue or not. Much of the logistical components of therapy are now set:
We will be working together
There will be homework
We won’t just be talking about the negatives
We will be using tools and frameworks to help guide us
We’re going to stay as focused as possible
Taking back control
We’ve used the matrix in several different ways already, but there’s still one more crucial component that hasn’t been covered: the center circle. Before moving on further, ask your client to draw a circle in the center of their diagram so that all four boxes are connected.
“There’s one last thing I want you to do with this diagram. Draw a circle right in the middle, just like this. Now I’m going to ask you a couple questions and when we’re finished we’ll write something in the circle.”
Client: Okay.
“For you as an individual, who gets to decide who and what are important to you?” [Pointing to lower right hand square]
Client: . . . I do.
“That’s right. And who’s the person who experiences all of this stuff down here, even when nobody else can tell anything is going on?” [Pointing to lower left]
Client: Me.
“That’s right. And, luckily, who is the person who gets to decide how you use your hands and feet, voice, time, and energy?” [Pointing to top two squares]
Client: Me!
“Yes. You see, there’s a YOU there at the center of your life. So go ahead and write the word ME really big in the middle of that circle. You’re the one who gets to decide who and what are important to you. You could have written anything in that box, but you didn’t, you chose to put these things. That says something about the kind of person you are.
Only YOU can actually experience the stuff that goes on on the inside of you. Nobody else can be inside your head. So that means only you have the power to respond to that inner stuff.
And only YOU can choose how you use your hands, feet, voice, time, and energy.”
Client: Wow, that’s totally right.
“We actually have much more control over our lives than we tend to think we do. Especially when we get caught up in one of these stuck loops, it can feel as though our lives are shrinking down around us. A large part of the work we’ll be doing together is learning ways to tap back into that level of control we actually have over our lives so that you can do what matters to you.”
As you say this to your clients watch their facial expressions and other body language. Control need not be a bad word in ACT therapy. The majority of our clients have gotten stuck trying to apply a level of control that they don’t have over their thoughts, emotions, memories, and other inner experience, but that doesn’t mean that they don’t have control at all. We do have some ability to control our lives and where they are headed, and to the degree that we do have control we want to exercise it. I find that it is at this point in introducing the matrix that clients feel the most hopeful about the therapeutic process to come.
Before moving on to the next steps in the process, take time to ask clients what they thought of laying their life out in this way. Without fail clients will tell you how helpful it was to put it down on paper, how looking at things this way “makes a ton of sense”. Once a client said something that stayed with me, “In a good way, it’s simplistic. It’s everything going on in my life, all laid out.” These two sentences encapsulate the ACT matrix in my view. In a good way, it’s simplistic. But as you’ll see through the rest of the book the matrix grows dependent on need.
The first homework session
Homework assignments begin immediately with ACT matrix work, but unlike most homework assignments clients tend to be eager to get these done and report back. The first assignment that we give clients is that of tracking the toward and away moves they engage in throughout their days between this initial session and the next meeting. Here’s a spiel that I use to help set this homework assignment up:
“Remember I said I’m going to ask you to try certain things out at home? That’s going to start today. I have a little task I’d like you to complete.”
Client: Okay.
“What I’d like you to do between now and next time we meet is to keep this system of toward and away in your mind. You can take your sheet home to reference it. I’ll keep my copy. And what I want you to do is see if you can notice yourself making toward moves and away moves throughout your days. You see we’re constantly making these moves. As soon as we wake up we start making toward and away moves. Almost everything we do can be boiled down into this system. Even something as simple as ‘What am I going to eat for lunch today?’ can be boiled down into toward and away.
Here’s an example. I’m an adult, I can go to lunch today and eat anything I want. I get to decide. I could eat 16 donuts for lunch if I wanted to. But let’s say I wasn’t a therapist. Let’s say I was an actor, and I was trying to gain a lot of weight for a role. 16 donuts in that case might be a toward move. And if I was an actor trying to lose weight for a role, 16 donuts might be an away move for me.
You see it’s not the donuts that get to decide if it’s a toward or an away move. It’s you. Some toward and away moves will be very easy to see, others will be harder. Just see what you can keep track of.”
Client: I see.
“You don’t have to write them down or anything like that. Here’s how simple it might look. Two or three days from now you might catch yourself doing something and think ‘Oh wait! This is one of those away moves we talked about!’, or ‘Oh snap! This is one of those toward moves!’ That simple. Is that something you think you can do?”
Client: Yeah, I can do that.
“Great. That’s what I want you to do between now and next time we see each other. When we meet again we’ll start off that way. I’ll ask you what you noticed in terms of toward and away and we’ll talk about it.”
At this time your work with the matrix is officially complete. All that is left to do is schedule the next session, answer any questions, and go over any last bits you need for your intake process. You’ve also set the client up for the following session, and all future matrix work. They may not know it yet, but the engine of psychological flexibility has just been kick started.
Session outline
Step 1: Preview the session structure for clients
Step 2: Take a functional contextual history
Step 3: Begin sorting client content into matrix
Step 4: Set goals and contract for therapy with client
Step 5: Review how you will use the matrix to help the work
Step 6: Give homework assignment
Step 7: Schedule next session and address any questions