#092: Acceptance and Commitment Therapy Training (ACT) | Interview with Dr. Jonathan Tarbox

acceptance and commitment therapy

Dr. Jonathan Tarbox credits his professional journey into autism to a gung-ho mom in the mountains of Vermont way back in 1997 who wanted to help her son with autism. It’s so amazing how many professional careers rest on the backs of these passionate moms and dads who simply wanted to help their children lead happier and healthier lives. Today, Dr. Tarbox teaches parents and professionals how to use Acceptance and Commitment Therapy to choose healthy habits in small, manageable ways.

ACT is a way of learning new habits, of responding to our own thoughts, emotions, and bodily sensations. The way society has taught us to respond to our emotions can actually make the situation worse, and ACT is a way of retraining a person to recognize and sit with these feelings.

ACT has benefits for autism parents, burned out BCBAs, and some children with autism, and because it’s modeled on ABA principles that nobody is broken, it should feel familiar to anyone who’s worked with ABA before. It’s really about understanding what’s most important to our hearts, and then using small behavioral changes to bring our actions in line with our values.

One of the things that I find difficult is being too positive when you talk to someone who’s dealing with a new autism diagnosis. Even though I’ve seen so many positive stories over the years, you don’t want to dismiss someone’s grief. How do you find that balance? Dr. Tarbox shares some ways to manage that delicate balance of honoring someone’s pain while still giving them hope for the future.

TODAY’S GUEST

Dr. Jonathan Tarbox is the Founder and Program Director of the Master of Science in Applied Behavior Analysis program at the University of Southern California, as well as Director of Research at First Steps for Kids. Dr. Tarbox is the Editor-in-Chief of the journal Behavior Analysis in Practice. He has published five books on applied behavior analysis and autism treatments, is the Series Editor of the Elsevier book series Critical Specialties in Treating Autism and Other Behavioral Challenges, and an author of over 90 peer-reviewed journal articles and chapters in scientific texts. He is an advisory board member of the Women in Behavior Analysis convention and the ABA Task Force for Social Justice. His research focuses on behavioral interventions for teaching complex skills to individuals with autism, applications of Acceptance and Commitment Training (ACT) inside of applied behavior analysis, and applications of applied behavior analysis to issues of diversity and social justice.

YOU’LL LEARN

  • What is ACT and how can it serve parents and professionals?
  • The six overarching general skills that ACT teaches.
  • Jonathan’s favorite visualization technique that teaches a person how to refocus their attention.
  • When ACT is not a helpful technique to employ.
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Transcript for Podcast Episode: 092
Acceptance and Commitment Therapy Training (ACT) | Interview with Dr. Jonathan Tarbox
Hosted by: Dr. Mary Barbera

Mary: You're listening to The Turn Autism Around podcast episode number ninety-two. And today we have a special guest, Dr. Jonathan Tarbox. And I'm going to introduce Jonathan in just a second. But I just wanted to say thank you to those of you who have listened, who have downloaded, we are surpassing two hundred and eighty thousand downloads in about a year and a half since starting the podcast in January of 2019. We've had such a good response from both parents and professionals. So if there's someone out there that's in the autism world that doesn't know about my podcast, I'd love it if you would share MaryBarbera.com/podcast. If you would tell them about the podcast, leave a reading and review wherever you are listening at Apple podcasts or Pandora, or I-Heart radio, wherever you're listening. I would love it if you would leave me a reading and review and tell others to also search.

Mary: And one of the really great benefits for me of starting the podcast is to meet people like Dr. Jonathan Tarbox, who I had never met before and just, you know, really learning myself about ACT, which is a treatment package. So today we are talking mostly about ACT, acceptance and commitment training or therapy. We're going to talk about the parts of it, what it actually is and how it can serve both parents and professionals as well as kids with higher language abilities. Then, you know, if you're if you have a child that's newly diagnosed or are non-verbal at this point, the treatment package is going to be mostly for parents and professionals. So today we're talking specifically about how to help parents using the techniques within the ACT approach.

Mary: So Dr. Jonathan Tarbox is the founder and program director of the Master of Science in Applied Behavior Analysis Program at the University of Southern California. And he's also the director of research at First Steps for Kids. He is the editor in chief of the Journal of Behavior Analysis and Practice. And his research focuses on behavioral interventions and teaching complex skills to individuals with autism and without autism, using acceptance and commitment training. So all of the show notes are going to include all of the resources that Dr. Tarbox talks about. That'll be at MaryBarbera.com/92. I hope you enjoy this special interview with Dr. Jonathan Tarbox .

Mary: Sothank you, Jonathan, for spending some time with us. It's great to me. You are kind of in person. At least we're over video and to get to know you better. So thanks for joining us.

Dr. Tarbox: Yeah, thanks for having me. It's really a privilege and an honor. I appreciate it.

Mary: Excellent. So I know we're going to jump in and talk about a big research interest of yours being act acceptance and commitment, training or therapy. So before we get to that, I always like to start and describe your fall into the autism world fall.

Dr. Tarbox: I like that. Never heard that before. Yeah. So I was a political science major studying nonviolent community action and nonviolent compassionate community building. And I stumbled on a job ad for a tutor, for a kid with autism. I was going to a little liberal arts school in the mountains in Vermont called Marlboro College. And I went and checked out this job and turned out it was an ABA program, home-Based ABA program. There were no BCBAs up there at the time. This is in 97, I think, or 98.

Mary: And there were there was no such thing as a BCBA in 1997.

Dr. Tarbox: And so it was a mom putting together the best program she could for her kid and their cute little farmhouse in the mountains in Vermont. And so she had bought like VHS cassettes on how to do ABA. And we sat her living room and watched the cassettes and tried to imitate what the traders were doing and stuff and cobbled together this program for her kid. Her kid was super cute kid like bright orange hair, cute freckles and everything. Severe challenging behavior. He didn't make it easy on us. And we are doing our best, you know, and looking back now like we did a terrible job. But, you know, but even with that, just the basics, you know, like being present, showing up, prompting reinforcement, prop fading all that. The kid was making progress.

Dr. Tarbox: And I got hooked immediately because there was like a science to it. And also that the piece where you can actually help people and not just kind of try hard to do your best, but actually be accountable for is it working? And if it isn't working, let's tweak it, you know, and you can see the behaviors go up on the graph. So satisfying. And mostly, just like the mom's commitment was the main thing that hooked me was that I know she was there for her kid 100 percent and that she was all in, you know. And then asked me and the other college students, including my wife at the time, were like just fully engaged and just doing something hard and scary, but like meaningful, more meaningful than anything I'd done previously. So I was hooked. And then I got now.

Mary: It's so funny because I'd say out of the professionals who are not parents of kids with autism are the professionals almost, I should go back and actually review. But it's a very similar story with a lot of falls into the autism world as they responded to an ad in college to work with a child with autism, with a super gungho mom at the wheel. And yeah, it's really nice to hear as a parent myself, that's how I fell into the autism world. But to hear the professional journeys are very similar in a lot of ways. So go ahead. So then they after you were hooked then what did you do?

Dr. Tarbox: Well, I know. And I did. And I wanted to say, like I often think and I think it's true that most of us in the field, the baby, say, oh, our careers to moms, to autism moms. Like that's why our jobs exist, because of the blood, sweat and tears of thousands and thousands of autism. And some dads do. They're doing their part, too, sometimes. But really, you know, it's the moms that are right there in the time. It happened a lot of times.

Mary: And in fact, I wrote I wrote a paper when I was getting my PhD ever to paper and discovered in the foreword of an ethical book, I think, or How to Think Like a Behavior Analyst book. But in the foreword of that one of those books, it was stated that the entire BACB, the entire Credentialing Board of Behavior analysts owe it to Let Me Hear Your Voice, which is a book that was published in nineteen ninety-three, which mom obviously had as her Bible as I did to start that program. So the demand that that book created for people that knew what they were doing. So like the whole BCBA movement was started with a parent's account. So yeah. And I'm glad we touched on that a little bit. So go ahead. So you were interested in how, then you got farther.

Dr. Tarbox: Yeah. So that I got my first sort of like real ABA job at the New England Center for Children, which was amazing. Learned like the highest quality skill acquisition programming there. And then worked at Kennedy Krieger Institute, learned functional analysis and treatment of really severe behavior and really how to do research and produce data that are publishable.

Dr. Tarbox: And then super lucky to get into the university of Nevada-Reno in the P.H. D program and study with Linda Hayes and Steve Hayes and Larry Williams and Michelle Wallace and folks there back as a Ramona home far and really learn about the philosophy that that forms the foundation and really the difficult conceptual pieces that really form the foundation of our science and also allow us to extend our science into more complex human behavior as opposed to relatively simple functional communication and challenging behavior, things like that. And then. Yeah, and then that was kind of just took off from there. And now I was at Card for 10 years as the research director.

Dr. Tarbox: Now I'm at First Steps as the research director and I founded and I'm the director of a Masters and ABA program at the University of Southern California. And that's my gig now. Then I've got a million other side hustles that are telling me, like, you know, editing books and things like that. Editor in chief of the journal Behavior Analysis and Practice, which is sort of the Premier Practitioners Journal and ABC. And that term is coming to an end. Thank goodness. It's been one of the coolest jobs I've ever had. But just it's too much. So I'm going to be finishing that up this around New Year's 2021 and. Yeah. So that's what I do.

Mary: And how often is that journal published?

Dr. Tarbox: Four times a year.

Mary: OK. And is it all electronic?

Dr. Tarbox: Yeah. You can still subscribe to paper copies I believe. I don't know that anyone does.Yeah. And most people access it online. Yeah.

Mary: Okay. Great. So I'm assuming when you were at the University of Nevada with the Hayes, Hayes I guess that's how you say it. Steve Hayes and Linda Hayes, is when you got involved with the whole ACT philosophy or what is ACT, what does it stand for? Let's just start there.

Dr. Tarbox: All right. Let's start there. So ACT stands for acceptance and commitment therapy or when practiced in ABA and other sort of non-psychotherapeutic disciplines, for example, like. Physical therapists use it a lot. Life coaches, coach at athletic coaches, use it in settings that don't involve psychotherapy for psychological disorders. It's called training and it's a little bit different. We can talk about the difference. But basically, ACT is a way to learn new habits of dealing with our own internal. So I'm mostly going to toss out the behavioral jargon and just talk like a normal human and they'll be a few crusty old behavior analysts know apoplectic listening to your podcast.

Dr. Tarbox: But they'll survive. But basically, it's a way of learning new habits, of responding to our own thoughts, emotions and bodily sensations when those are difficult. When those are challenging or aversive in behavioral jargon. And so it turns out that most of the ways, most of the habits that we've learned and that society have taught us about how to respond to difficulty or adversity usually actually makes them worse and usually pushes us towards avoidance, like unwillingness to fully experience the difficulty of life. And that's fine when it doesn't matter. But it turns out the more time we spend avoiding and just trying to feel good rather than really fully feeling what's going on, the more it moves us away from stuff that we really care about.

Dr. Tarbox: And so our lives can become smaller and smaller around the things that we care about the most. And so we have parents of kids with autism who feel imprisoned in their own home. So we have BCBAs to feel completely constricted and destroyed by their own stress and burned out on the job. And we have just everyday humans, you know, all of us who feel powerless to do things like change our diet, to eat something healthier, eat more plants or whatever you care about what's healthy food or get outside, get some exercise. A lot of those challenges come down to how we respond to our own thoughts and feelings. And so ACT is about just it's a skills training procedure to just train a bunch of really healthy habits that help us identify what we really care about. Choose small doable goals and set goals and just get moving and choose behaviors that move us towards what we really care about. It's small but meaningful ways.

Mary: So as I'm listening and I know not very much about ACT, so it's good for me to learn with anybody out there that's listening, that that doesn't know a lot either about this subject. But it sounds like, you know, what can happen if you aren't tackling or becoming resilient and feel making lemonade out of lemons and so forth. Is that you can be addicted to substances or things? So, it sounds like it could it could be really powerful within the addiction world, too.

Dr. Tarbox: It is. Yeah. So ACT was originally developed for behavior analytic psychotherapists to address sort of typical problems of psychology, for example, anxiety, depression, substance abuse disorders, chronic pain, things like that. And there's, you know, I think 200 or 300 randomized controlled trials now published in scientific journals showing that it works for those traditional challenges of psychopathology. And, yeah, super effective for those.

Dr. Tarbox: But the neat thing about it is the model behind ACT, which, by the way, is the same model behind all of ABA is the assumption that nobody's broken. There is no thing inside you that's broken. There is no cause inside you that's deep, dark, scary and broken and that we need to fix. The assumption is we're all perfectly human humans and the choices that we make on a day to day basis greatly impact the quality of our lives. And so a lot of the sort of functional problems, if you're thinking about behavioral repertoires that are problematic at the heart of anxiety, depression, substance abuse, a lot of those same basic functional issues are the same for anybody who doesn't have the label for their for their behavior, but still just has a hard time making behavior changes that really matter.

Dr. Tarbox: And a lot of what it comes down to is avoidance, avoidance of wanting to feel sad. Avoidance of wanting to feel scared. Avoidance of wanting to feel angry. Avoidance of wanting to contact thoughts like I'm not good enough. I'm a bad mom. I'm a bad dad. I'm too tired. Whatever the thoughts are, they get in the way when you try to do something that matters to you. The unwillingness to sit with those thoughts and experience those thoughts and the unwillingness to experience the emotions that come along with them, all of the behaviors that we build up that are escape maintained, basically. So eating too much, drinking too much, sleeping too much, too much, you know, too much YouTube, too much Instagram, whatever. Right. All of that. If it gets in the way of us actually doing stuff that matters deeply in our hearts on a day to day basis. All of those can be problematic. And so ACT is about building new habits for sort of tweaking those and creating flexibility around those.

Mary: Oh, and I'm sure that the research on happiness also comes into play here and at my goals is for every child, whether they have autism or not. And every adult to be as safe as possible, as independent as possible and as happy as possible. And so the whole happiness, mindfulness, life, therapy kind of things. It sounds like it's molded. So is this like a methodology and approach, a tool like what exactly is ACT?

Dr. Tarbox: It's a treatment package. So it's a treatment package. Just in the same way that something like functional communication training is a treatment package. So functional communication training consists of identifying the function of some behavioral excess and placing it on extinction as much as possible and then teaching some other alternative behaviors that will then result in that same functional reinforcer. Right.

Dr. Tarbox: So in other words, teaching people ways to get what they want through behaviors that are more adaptive and more successful in their daily lives, rather than having to engage in behaviors that can be destructive to get what they want and what they need. ACT is the same thing. It's just a lot more complex treatment package. There's six sort of overarching general skill repertoire that we're trying to train. Whereas in maybe something like, you know, FCT, there's kind of really just two sort of topographies and they all have the same function. You know, but it's the same idea. We've got sort of behavioral repertoires that we want to train. And we could talk about some of the most important ones out of those six, if you like, or don't want to.

Mary: OK. So do we use the ACT treatment for parents, for professionals, for kids with autism? Like what is most common or it might help us if we come up with a person that we're going to help. And then we apply the principles.

Dr. Tarbox: Yeah, absolutely. I love it. So the answer to that is ACT can work for anyone whose language and thoughts are getting in the way of them being the most successful in whatever setting that matters in their life. And so have you ever met a child with autism whose language and thoughts are getting in the way of being successful? Absolutely right. Have you ever met a mom or a dad? Right? Absolutely. How about a BCBA or an RBT. Of course. Right. So the way that it works, though, is through creating flexibility around verbal behavior. So if a child just doesn't even have enough verbal behavior yet to be inflexible about it. Then probably they're not quite ready. Right.

Dr. Tarbox: But as soon as they're able to start describing themselves, describing others, saying things, saying how things should be or have to be or could have, should have, would be any of that stuff, any responding to the past or the future or the sorry, you have the past or the future in ways that are rigid and given the way any of that doesn't matter if you have autism, don't have autism, what diagnosis you have, if your language is getting in the way, that act is likely to be helpful. So if you want, we can imagine like a particular kid or a parent or something.

Mary: I actually would like to. Let's focus on a parent who just got a diagnosis of autism, because most of the kids I help, you know, my first book, The Verbal Behavior Approach, my new book that's coming out in the spring Turn Autism Around, are really for kids who are not conversational. And so they probably just don't have enough language for us to really apply it. But I work with a ton of parents, and I think it would really help the professionals too to help that new parent with a new diagnosis of autism who is stressed out, overwhelmed, you know, is reading all this stuff on the Internet, doesn't know what to do, who to trust. You know, maybe having some marital conflicts because of this diagnosis may have to quit her job or decide on daycare. And there's just a lot of you know, has siblings. So why don't we kind of go through the six things that we're trying to teach this mom of this really diagnosis? I think that would might be more most helpful.

Dr. Tarbox: Yeah, it sounds good at first. I just want to say I really empathize with folks that are sitting in that situation right now. It's really tough for parents under any circumstances. And I can only imagine right now, under the COVID circumstances, being stuck at home, having limited access to services and all that. How stressful that's got to be. It's just a whole other level. We don't even, we have no idea what like we have never experienced this before. So parents who are doing that are, you know.

Mary: Well, exciting. I just want to jump in here and not to. We've had several parents actually within my online courses and community when I've said, like, what are you struggling with, with COVID? And a few of them have said, like, COVID, it is actually a blessing for us because we have taken your online course. We've learned what to do and we've seen amazing progress. One of the women that's seen amazing progress is featured on podcast episode number 78. So MaryBarbera.com/78. Is a mom with a new diagnosis right before COVID and the COVID shutdown took my course one month went from two words. Two hundred and eighty words and phrases. And just all kind of progress. And so it's possible. And that's not to diminish anybody, because most of the parents of children with new diagnosis are just not in the same shape as Michelle, who's featured on that podcast. But so I do think that focusing on that. But it is a totally different situation because of COVID, because services are shut down.

Mary: They're virtual. You know, if you're used to your child going to a clinic, they may not be able to go or they may have to wear a mask and they're not wearing a mask. And that's all a part of it now, which makes it super, super stressful. But Ok. So back to our mom with a new diagnosis of a two or three-year-old.

Dr. Tarbox: OK. So the first thing I'd say is all of us have learned patterns that aren't helpful. And soACT part of ACT is just noticing our own behavior, bring attention to our own behavior and our own thoughts and our own emotions and our own physical sensations. And so they talk about that as present moment awareness training or mindfulness.

Dr. Tarbox: And basically, it's just the habit of practicing, noticing, what's going on. And practicing, noticing what's going on without judgment. And so whatever task you're engaged in, we notice as humans, our minds will wander and start thinking about something else. And so maybe the task we're engaged in is trying to get my son dressed in the morning. And then I notice suddenly wait a minute, I'm not even paying attention to getting my son dressed. I'm thinking about the school district or the IEP. Or I'm thinking about the argument I had last night with my husband or I'm thinking about, you know. Right. 18 other things.

Dr. Tarbox: The one thing I'm not thinking about is you right here, my son, and getting dressed. Right. And that's a very normal human thing. But things get difficult. Our minds start to wander. Think about other stuff. And so present moment training is about just practicing noticing that and not beating yourself up over it and just practice. When you notice that. Redirect your attention back. Do this. Really zoom in and see if there's something you can notice right now in this moment about your son while you're getting him dressed. It's the feeling of the texture of the fabric of his clothing. You know, maybe it's a little crooked smile or a freckle or something, or maybe it's a little hair out of place or something, you know, really zooming in and slowly being present.

Dr. Tarbox: And then, of course, your attention wanders. You start thinking about something else and practice just non judgmentally bringing it back. So you can think about it as kind of like analogous to driving, like every one of us has been driving somewhere. And suddenly we realize that our attention is not on the road in front of us. What do we do? We just bring our attention back to the road. Right. That's critically important. Life and death situation. It's not life and death in our daily, small, daily moments with our kids and with our family. But it is really, really important. And so that's just one small thing we can do is practice getting back in the present moment where our attention wanders and you can do the Headspace app and all those meditation things. But all of that comes down to generalization. Try to generalize to your daily life.

Mary: Now, is that the acceptance part of ACT or is that something else? Yeah.

Dr. Tarbox: So all six skill repertoires that we're training all work together to support each other. That particular called the present moment awareness skill in the ACT literature. But here's the interesting thing is when you practice the habit of noticing what's actually showing up. And so that includes noticing your thoughts and noticing your feelings and then redirecting your attention back to whatever is really going on. When you do that, you'll notice, oh, if I'm paying attention to my feelings, sometimes I'm not super happy about those feelings. Sometimes I might notice, like I'm feeling stress or I'm feeling dread or like I'm feeling hot and sweaty and like heart racing, you know, or maybe I'm feeling despair. Maybe I'm feeling hopelessness.

Dr. Tarbox: And so if we do behaviors to try to make those feelings go away, very, very often lead us away from being the best we can be in that moment in terms of what we really care about. So it does involve acceptance. And acceptance, just all that means is showing up for the feelings, practicing, experiencing the full range of human emotions that are normal, healthy part of being in a situation that you're in. If you're a parent of a newly diagnosed kid, it is really normal and really healthy to feel a lot of emotions, not just one emotion. You don't have to be super mom and only feel happiness and hope. That's great to cultivate those things, but that is not human, to only feel happiness and hope when you're facing difficulty. It's critically important to open up to all the full range of experiences.

Dr. Tarbox: And so on any given day, it's really normal and healthy to feel sad. And at some other point in that day, to feel hopeful and at some other point that day to feel total despair and to even have the thoughts. I can't do it. It's not going to work. What is this future going to be like? That's all normal and healthy. And so the acceptance skill is about just opening up to experiencing those. And when you notice those show up. See if you can actually, you can practice like a physical metaphor, like open your arms to like show up fully and just really notice. Where in my body do I feel the grief over the diagnosis? Where does it show up? Is it my chest? Is it a sinking feeling in my gut? And just orient your attention to it and sit with it. See how long you can feel whatever feeling is genuinely showing up in the moment.

Mary: So we as behavior analyst, you know, we show up even for my online community. You know, there's not a lot of. I don't know. I mean, I don't feel like I'm able to, you know, it's not in my wheelhouse to give therapy. Like I have worked with parents who have had marital struggles and they come in and, Well, he said this and that. And he doesn't understand. And, you know, and you're like.

Mary: Like, I'm not I mean, I'm married, but I'm really, I'm a behavior analyst. And maybe the book, What Shamu Taught Me About Marriage, like I don't know. It's like so you, the professionals out there, they go into a house for a new visit and we've got all this overwhelmed stress, you know, like, OK, how can we help them without, you know, like my reaction is like, OK, you know, I'm going to tell you what I wanted to know about how to kind of move forward and that sort of thing.

Mary: These are normal feelings. But like, I probably discount feelings more than, you know, I should. And like how do we really tackle this so that we're going and we're being supportive without this wallowing in despair? It's like, OK, you know, we're on the clock. We got to get moving. And we, you know, making total progress is also super motivating and good for the kid and good for the parents.

Dr. Tarbox: Yeah, well, we're kind of at a disadvantage in the behavior analysis field because we don't get a lot of training on building rapport with parents and compassion and empathy and active listening, things like that. So we've got to kind of learn that stuff. Most of us outside of our BCBA training programs, unfortunately, other disciplines like social work, even speech and language, and OT. Even though it's speech, language, and OT; they're not doing psychotherapy, but a lot of times they do get trained on how to just show up for the parent. And listen.

Mary: Right. A lot of it. Well, I'm a registered nurse, so I have a lot of training with compassion and listening and not jumping in and being like, you know. And so that was really helpful. Plus, I was a mom of a child with autism. So now it's like I'm really empathetic because I know because I personally been there. But then again, that's a double-edged sword, too, because just because I had the experience 20 years ago, that doesn't mean that I know what they're feeling.

Dr. Tarbox: Of course. Yeah. And each person's experience is unique. But for BCBAs, it's really important to remember we're always using all of these ACT approaches or procedures or whatever in the service of overt behavior change that matters to the family, to the child. Right. So it's never just about changing people's minds or hearts or something like that. It's not what it's about. It's about creating new, flexible ways of talking about plots and feelings in the service of changing overt behavior. So let me just give you an example. If a parent if you're a BCBA, and a parent says to you something like, I just feel so stressed out of my mind right now, I don't know. I'm just so worried about my child's future. It's hard for me to even focus on what the behavior plan today, you know, sort of a classic if we're going to stereotype a classic thing that really society has taught us in general, and that may be a lot of BCBAs might be guilty of, is try to talk the parent out of feeling bad and try to talk the parents out of the negative thoughts and feelings.

Dr. Tarbox: And if that works, great, go for it. But there's actually a lot of research that shows the harder you try not to feel something, the more it's there. And you're actually giving it power by trying to talk yourself out of it. And so instead of saying something like, oh, you know what? It's going to be fine. I promise. I've worked with so many kids. It's great. It's great. It's great. Don't feel stressed. Instead of that modeling acceptance would be something like, OK, I hear you. That's got to be really, really hard to be thinking about the future and to honestly not know exactly what's going to happen. Area. And now today, let's focus on something we can actually do today, even when we don't know exactly what the future is going to hold. So what can we do right now in this session to today as partners to move towards that future that you care about for your child?

Dr. Tarbox: Does that make sense? So rather than trying to talk out the negative thoughts and feelings, show up for them. Acknowledge them, don't wallow in them. Don't go into the root cause. Well, how did you feel when you're a kid and did somebody mistreat you? We don't need all of that. We don't need it. Show up. Make room for the negative thoughts and feelings and say, OK, what do we care about today? What can we do today to move towards what we really care about? What do we care about? That's values. What can we do today in one small way to move towards that? That's committed action.

Mary: Does it help if we tell them that, you know, they're not alone? This is very common to feel like this? Does that help or hurt?

Dr. Tarbox: And that's a big part of the acceptance repertoire, too. It's just normalization. I mean, you don't want to lie to them. But if it is normal human emotion. Yeah. You attack that like, look, it's really, really, really human. You know, I hope that you want to be a whole human. And if you do, you're on the right track. It's human and normal and OK to have those thoughts right now. You don't meet. So it's one of the biggest myths that society has sold all of us. And it's really called mentalism. But what it comes down to is if you want to do a good job, you have to be right in the head or in the heart. You have to have thoughts and feelings that are healthy and optimistic, and then everything will be fine.

Dr. Tarbox: And we all kind of buy into that. Even if we don't say those words, we act on that basic model, that basic assumption. And it turns out it's totally bogus. It's totally false. And we know that. Like all of us parents who have really struggled. Know that that even when we're feeling awful, we can still show up and work really hard. And even when we're feeling great, and everything, oh we're so happy. Sometimes things are terrible. So our thoughts and feelings don't need to match. We can choose behaviors that we really care about in the presence of a variety of thoughts and feelings. Some of them make it easier. Some of them don't. But we can still make choices that we really, really, genuinely value and show up fully in the moment.

Mary: OK. So commitment. Is that the same as committed action, is that the same goal setting are like, oh, how does that work?

Dr. Tarbox: Yeah, that's 100 percent ABA. That is an ACT is not something different than ABA act as a approach that was created from behavior analysis by behavior analysts based on basic research on real governing behavior, stimulus equivalence and relational frame theory. You don't have to know all that stuff in order to be effective, in order to integrate ACT into your practice as a behavior analyst.

Dr. Tarbox: Although it helps and it will make it a lot more efficient, just like, you know, understanding the theory behind anything we do makes it more effective. Right. Being conceptually systematic. Several Risley, 1968. But not no, my geeky digression. I totally lost my train of thought. Oh, that commit manpower. Yeah. So that's just goal setting.

Dr. Tarbox: That's all it is. So the committed action part is identify what you care about. That's the values. So I care about my son's independence, OK. And then identify and then set a small behavioral goal for myself that will move me towards that. So maybe today I can spend five minutes on the homework. That might be BCBA assigned to me. I could spend five minutes helping my son generalize what he learned in ABA therapy today.

Dr. Tarbox: That's one small behavior I can do that I believe and I hope will help move me and my son towards a future of being more independent. Maybe a different value is spending moments of joy with my family and my kids. And so maybe your goal this week or today is going to turn off all the electronics. All of it. All the electronics in the house. And this is like after my child has gotten the reinforcers, got their electronics or whatever, looking to rip it away from them. But we're going to find a moment to just quiet everything down and find stillness, even if it's five minutes before we then go back to our crazy circus life.

Dr. Tarbox: Like just turn on some calm music. Turn the lights down low. Hold my child, snuggle them, whatever the kid's going to love and you're going to love and just be still and quiet for five minutes. That's just one little teeny behavior. Is that going to solve everything? Absolutely not. But it moves you towards that value of finding joy and appreciating love in the moment with my kids. If that's your value. The values are individually chosen values. No one else can tell you what they are. And it's based on your verbal history, you�re learning history and your history of condition.

Mary: So when you go in and you know you're a professional and you go into a parent with a new diagnosis and a child and they're overwhelmed, then you say, OK, you know, you empathize. You say, you know, it is tough. It's very normal to feel like this. We have no you know, even for a typically developing child, I mean, my son by others, my typically developing son is in med school right now. We did actually a sibling interview with him before he went back to New Orleans. And that's episode number eighty-five is actually becoming one of my favorite episodes already.

Mary: But even with him, I mean, nobody has a crystal ball to see where he's going to be in five or 10 years. And, you know, nobody had a crystal ball with him when he was 18 months and Lucas was three when Lucas was diagnosed with autism. So, like. But then I feel like I'm talking people out of their grief, you know? You know, it's a balance of not being too. Like, here's a zillion examples where, you know, not to worry, but, you know, worrying is so normal. So, like, I want to make sure, like, I'm not, you know, placating people or dismissing their feelings.

Dr. Tarbox: Well, you know, and a core foundational process in ACT, and by the way, in all of a NBA is pragmatism. And so we do what works. And do we need a change of behavior? Well, only if it matters in some really important way. Do I care about this behavior that I'm doing as a parent. Do I need to change that? Well, is it getting in the way of something you really care about? And if it is great. If it isn't. Don't worry about it. Work on something else.

Dr. Tarbox: You know, so like, should you be experiencing the sense of grief and loss that you're having right now when your child is newly diagnosed? Yes, absolutely. Is it healthy to notice it and spend time actually having those experiences and maybe turn everything else off and just sit with that grief and that and that fear? Is it healthy to do that? Absolutely. Is it possible to do that too much to where then that gets in the way of doing other things that really matter for you and your child? Absolutely right. So it's about being pragmatic and it's about looking at and just noticing our own behaviors, not just mentally, but just noticing.

Dr. Tarbox: What am I spending my time on and what do I really care about that it's moving towards? And if you try to turn off all the negative emotions, I guarantee you it's going to have a negative impact. You're going to end up doing a bunch of other behaviors, drinking too much, whatever. We already talked about them, that get in the way of them fully showing up for something else that really matters, like doing the hard work with your kids or getting the bills done or showing up for work or getting on the zoomer or whatever it is. And so it's always a balance. Not about changing how you feel.

Dr. Tarbox: It's about getting better at experiencing however you feel and then making room for it and then moving on to something that you can do, something tangible that you can do. Today, every single day of our lives, when we're having the happiest day of our life and all the way to having the worst day of our life. Every single day of our lives is an opportunity to choose one small behavior that fills our life with meaning and purpose on that day and that moment every day, even at a funeral of our loved one, especially at a funeral of our loved one, maybe one of the worst days of our life. We have choices.

Dr. Tarbox: First of all, did we even show up and showing up really matters. And while we're there, do we close ourselves off or do we put our arms around the people that we love? And do we share that moment with them? Those are behaviors. Those are choices. We always have those choices every day. And they're not supposed to be easy. They're supposed to be hard. And you're not supposed to be perfect. Nobody is. You can't be. What you're supposed to do or what would be useful for you to do is work on spending more time contacting what you really care about in the moment and choosing small behaviors that are moving towards that and treating yourself with kindness.

Mary: So I know we want to talk a little bit about the ACT. It used to be acceptance and commitment therapy, and now it's also acceptance and commitment training and the different between therapy and training. And also, like when you go into somebody's overwhelmed, like at what point do you think, like, this is actually clinical depression? Does it? Or do I need to refer out for actual counseling and all that stuff that kind of gets rolled in? I think that T and act, Tony.

Dr. Tarbox: Absolutely. And so just to recap, acceptance and commitment therapy is act approaches to psychotherapy. So talk therapy and the people that do that are licensed psychologists, psychiatrists, social workers. And there's a few other disciplines. And of course, if you're in a different country or different culture, there's different standards. Right. Anybody else doing act if you're using procedures, principles, and ideally you're using behavioral conceptual analysis that form the foundation of to inform what you're doing. That's acceptance and commitment training. And so ABA folks fall in in that other category. We're not doing psychotherapy and we're not treating disorders.

Dr. Tarbox: We are helping people develop new skills that help them do behaviors, overt behaviors that are socially meaningful to them. And when you think about that's what we've always been doing. Right. So if you're in a busy professional working with family, with autism, will you sometimes need to refer parents out to other disciplines for help? Absolutely. If you if you think someone's suffering from depression or especially like self-harm or anything like that or real excessive anxiety or things like that, should you refer out to a psychologist who's an expert in treating those? Yes, definitely. If you are act trained, does that change that?

Dr. Tarbox: Not really, because you're not treating anxiety or depression inside of ACT, informed ABA. You're still just doing what we do, right? Like, what do we do in ABA? We help parents change their behaviors in ways that help them thrive and help their families thrive and especially help their child with autism diagnosis thrive. Same exact thing. We're not treating the anxiety or depression. We're not fixing their marital discord. None of that. As it turns out, when we help people develop healthier habits with responding to their own thoughts and feelings. They actually don't need has much psychiatric help, which is cool. Right. But that's also true of regular a regular ABA. Right.

Dr. Tarbox: When you see your child doing better, it makes you feel better. So it doesn't really change that. We still need to be really careful about scope of competence. We still need to refer out when it's necessary to refer out. What ACT does for ABA, folks, is just make our language more effective. And instead of using old stuff like just talking, trying to talk the parent into it or maybe nagging the parent into doing what we want them to do, or maybe just hitting them over the head with research. Well, the research says so. Here's the graph. You have to do it right. We all know how well that works. Instead of that, it helps us form new verbal habits as behavior analysts to talk about what really matters and to have those conversations to re-focus back on what works and to not take our own minds so seriously and to help parents not get so stuck on their own rules, focus more on what they care about what they can do today to move them towards.

Mary: Yeah, I think that's great. I had Bridget Taylor on one of the episodes, I don't know which one, and when we talked about her research on, you know, teaching behavior analysts, kind of the soft skills that are needed to, you know, pair yourself with parents. And, you know, I've heard over the years where, you know, a behavior analyst or even a teacher or a speech therapist, you know, would be like, well, the parents just totally not compliant with it. And they they're just, you know, they're just not doing it. And, you know, and I think it's probably because of my nursing background and my mom background.

Mary: But it's like if there's problem behaviors in this case, you know, the parent isn't being compliant with the behavior plan or whatever. There's problem behaviors on the part of the parent or the child. The demands are too high and reinforcements too low. Like that's just the way it is. And so, like, I'm very practical. And just like layman's terms is like you need to figure out. I mean, each family, each person has a lot of history of what they've been through, what they've tried, who they've listened to before, you know, that all come into play. And just like you said, nagging or jamming it down or presenting research is like you're missing the whole boat.

Mary: The parent is not buying into whatever you're trying to sell. And to help the child, you need to kind of unravel. What are the family priorities? You know, why do they want to do ABA or, you know, there's also a lot of different flavors of ABA. And some of the flavors are, I wouldn't do them. I wouldn't recommend them. You know, we've had Kelsey on on one of our first podcast, podcast number three. And she was driving her child, who was banging his head on hard surfaces 100 times a day, she was driving him to an ABA clinic where the BCBA, they were working on colors and he didn't even have the ability to mand or request. She had to bring him out in the community with a leash and a harness.

Mary: And, you know, she's got another baby who ends up having autism as well. She's a single mom. Like, you can't just say we're doing colors, so get over yourself. And we need to, by the way, put a helmet on this child who's two and a half years old, like. No. And like, I hate to digress on this, but, you know, you're a leader in the field. It's like, how do we not make, you know, all ABA is not created equal.

Mary: And like we're talking about, like adding ACT, which sounds great. And I think I'm kind of sort of doing some of it without even really knowing what I'm doing. But, you know, I need to learn more. But how do we educate people, parents and professionals on when to know if the ABA isn't really what you or I would....

Dr. Tarbox: Yeah. It's a really it's a tough one. It's a problem of quality for our whole field and frankly, for the entire field of psychology too. Most psychologists that you go see end up not being that helpful. And, you know, I hate to overgeneralize, but there is a major problem with quality of training in ABA. And that's why I founded the Masters program that I'm the director of is to create the highest quality training possible for new BCBAs. And it's a big problem. And the specific problem that you're referring to, I think, mostly comes down to function, thinking about behavior functionally. And we know that we're supposed to. But in that example, they're totally missing the point. They're just picking a topography that maybe matters, colors or numbers or shapes your letters. Well. Well, that's what my mentor taught kids as often goes on to do that, too. Right. There's just some specific topography.

Dr. Tarbox: You know, here's a list of skills that kids of autism need to learn. And I'll just pick one and teach it rather than thinking functionally. Like what is the function of the kid's behavior? Why is he willing to hurt himself? But what's going on really need and how can we help him get that through different behaviors? And then also, of course, thinking about the parent�s behavior functionally.

Dr. Tarbox: Shannon Penrod talks about this. You know her? She's an incredible autism supermoms. You've got to get her on the show. She's amazing. Penrod, P-E-N-R-O-D. She does the Autism Live TV show. It's a live TV show.

Mary: Yeah, I know. Oh yeah. I have been on that. Maybe I do now. Yeah. So yeah. Yeah. Yeah.

Dr. Tarbox: She says, look like if you're working with a kid, one of your clients. Right. And his behavior isn't changing and you're doing the skill acquisition plan and behavior intervention plan and it's not working. What do you do? You change the plan. You don't blame the child. And she said, but how about with parent training? When you do your parent training. Right. And the parents' behavior doesn't change. What do you do? And too often, especially poorly trained BCBAs blame the parent. The parent's just being noncompliant. The parent doesn't really appreciate all the work we're doing. The parent doesn't understand. The parent doesn't care whatever it or they go to some mental health and other parent is too stressed out.

Dr. Tarbox: They have too much depression. They have too much. There's too much to actually. No, like our job as behavior analysts is change the environment to help the learner change their behavior. So if our parent training approach isn't working for a parent, that means we need to change our approach and act as a way to reorient parent training towards what the parents genuinely care about themselves so that they have ownership over the parent training, so that it's about them. It's not about doing what the BCBA wants them to do. And that also is thinking about functional behavior. So if the main reason why the parent follows the behavior intervention plan that the BCBA recommends is to avoid the BCBAs disapproval or avoid the BCBA nagging or in extreme cases, avoid the BCBA threatening termination. Right.

Dr. Tarbox: If that's the reason why the parents doing it, then they're only responding for negative reinforcement. So they're doing something that a behavior analyst believes is incredibly important for their child, who they care about more than anything else in the world. But they're not doing it for the right reason. They're doing it for negative reinforcement to avoid disapproval from a behavior analyst. That's insane. So we're like teaching parents to do behaviors that really matter completely for the wrong function. I mean, that's completely wrong headed to begin with. And so the values work and act is about giving the power to the parent and saying, like, what do you really care about? You're not doing this stuff for me. This is your family. This is your life like, Is there anything inside of this that really matters to you that you are not willing to live your life without, that you're willing to stand for no matter what?

Dr. Tarbox: OK, how can we build parent training around that value? Whatever your stated value is and we'll work on it together. It's a completely different approach and really what it is it's positive reinforcement for the parents instead of negative reinforcement and it's verbally mediated positive reinforcement. The values work is the jargon is the augmentatal and the RFD terminology, but basically it's verbally mediated motivators operations. So when we say let's do this behavior intervention plan. So to help your child move towards a future of being independent and being able to advocate for himself, it transforms the functional, I'm getting too jargony. But it makes the behavior, the behavior intervention plan meaning and purpose. Whereas when we say do the behavior intervention plan, it's been shown to work in research. Where is the meaning and purpose in there for the parent? Maybe if the parents, a researcher, but not really. Right. And so it's just a different approach. That helps make what we do on a day to day basis really matter more rather than just being do it to avoid disapproval or whatever.

Mary: Yeah, sounds great. So we covered. Is there anything else that's super important about ACT that that we missed? I think it's pretty straightforward forward. The acceptance is being mindful, being present. Commitment is the committed action and goal setting and focusing on things you can change, maybe some really short-term goals and then training for us non psychologists who can incorporate these things to make everybody's life a little bit better and positive. It sounds like.

Dr. Tarbox: Yeah, absolutely. One thing I would like to add that we didn't touch on yet is the part that empathy and compassion plays in the ACT model. And it's not really, it's not one of the six sort of like stated pieces of the model, but it's woven into the entire thing. And it's the foundation and purpose behind all of it is to make the world a better place through love and compassion. I mean, that's the part that's why act was created, was to relieve human suffering and help humans contact a life more full of meaning and purpose. And in terms of human to human interaction, that really the core of that is empathy and compassion. You know, we could spend a whole obviously a whole episode just talking about that. But what I want to invite the listeners to consider is a be a tough one for a lot of parents is the possibility that taking care of themselves and being compassionate with themselves is just as important as taking care of their kids on the spectrum.

Dr. Tarbox: And that, I mean, in my experience at least, is the hardest thing for parents to grapple with, because the moms that I've worked with are willing to cut their own arm off if that's what it took to help their kids. Like, literally. Yeah. And so what society has taught us is we can't be vulnerable. We can't be weak. We have to be strong, you know, especially when it comes to taking care of our kids. And it turns out, you know, there's a good amount of research in the ACT, literature and compassion literature that the opposite is true actually. The less we are willing to be whole people within ourselves, the less we are available to show up for our kids and our family members. And so practice and compassion with one's self is actually really, really critical and so, so important. And so I've got like a just a couple of recommendations for that if we have time.

Mary: Sure. OK.

Dr. Tarbox: So here, imagine this. Think about it for those of your listeners who are parents. Imagine your kid maybe like 10 years from now, maybe 20. Let's fast forward 20 years from now. If you're a parent of a young child. So let's say maybe your child is in their 20s or 30s. And imagine that they're facing some pretty major challenges as we all are. And really, actually, for your listeners who are watching this, like you might even want to pause for a second, actually start to think about this and close your eyes. And when you're ready, press play again. Let's try to visualize your child.

Dr. Tarbox: Grown up, really, really struggling, trying to do their best and imagine what you would want for them in terms of them taking care of themselves. Like, imagine a picture of your child in the future as an adult and their lifestyle and what you would hope for them in terms of them taking care of themselves and them being kind to themselves and them treating themselves with respect and dignity. And spending more time on sort of like caring, nurturing behaviors with themselves as opposed to sort of destructive behaviors. If you care about that, if that matters to you in this moment. Now, reverse 20 years back to right now and ask yourself, where is your child going to learn those habits from?

Dr. Tarbox: Where's your child going to learn to take care of him or herself the way that you wish they will be able to 10 or 20 years from now? Modeling is the most powerful tool we have, and I'm not saying it's easy and this isn't to put guilt on parents at all. It's just to raise a red flag that the way that we take care of ourselves right now is teaching our children how to take care of themselves in the future when things really get tough. And what it really matters.

Mary: I think that's good. And I see that being a real stressor of parents of little children with autism who, you know, even parents of small children that don't have autism, hiring that mommy's helper or the babysitter or asking your mom or your sister or friend or neighbor to watch your child for a couple of hours. Like, it's not only good for you because you can take a break and you can have your child get used to somebody else.

Mary: It's actually good for the child because, you know, in an emergency situation or in, you know, just to have things generalized or you might learn like, oh, wow, I didn't I didn't really realize that Lucas could do that. But he was with somebody else who didn't understand his little nuanced way of asking for something, you know? So sometimes your child can surprise you and it makes you know, it's a lot of time that your child really needs engagement.

Mary: And the more you know and you might say, well, I have no money, Mary, you know, that's good for you that you can, you know, hire a babysitter. But it's like, be resourceful. There's church volunteers, there's mommies groups, there's teenagers, there's college students who need credits or need experience or there's insurance reform now. And, you know, with some advocacy work and you might be able to really get people to help you. And so when I get asked, like, do you think I should have the homebound instructor come or do you think I should get the church volunteer? I'm always like yes.

Mary: Because without people now, my house has been like Grand Central Station for two decades. I mean, there's literally hundreds of people that probably have to the code to my house and just walk in, like, literally every day, you know. But that's one extreme. But without people like. Lucas would do worse, but I wouldn't have been able to accomplish really much of anything without help. And so you only, your child only has one life and you want to get them to their fullest potential, but you only have one life, too. And if you spend 20 years full gunning it for him to learn colors or feature function class, and you don't take your time to, you know, develop your own interests and life, then it can be very depressing.

Dr. Tarbox: Definitely. And, you know, accessing the resources that you're talking about are so critical and it's worth spending the time on. And that can be sort of a longer-term battle. My invitation to your listeners is you can figure out something that you can do today to be more kind to yourself. Today. And so if you want a really easy way to do that is just think about someone else in a really similar situation to you. Imagine if you could step outside your body and see yourself from the outside. Or maybe your friends are buddies with another autism, mom or dad who who's in a similar situation. If you look at their life lifestyle right now, non-judgmentally, and if there was one small gift that you could give to them, that's sort of a lifestyle change. Just one little teeny gift. What would it be? And then ask yourself, can you do that for yourself? So it could be something really, really small.

Dr. Tarbox: Like if you normally stay up till 1:00 in the morning researching treatments for your kid on the Internet and you're not getting enough sleep and you're just, you know, haggard, maybe go to sleep at midnight, just want one extra hour of sleep, even 30 minutes extra sleep. If, you know, if you normally are getting in Facebook, jousting with people with competing views on Facebook, maybe consider setting a timer or just today, just try it once on how much time I'm going to spend on social media today grappling with other people, maybe just decrease that, try to decrease it by 50 percent so that it's still there. It's part of your life, but you give yourself permission to take just a little break from sources of sort of like aversive stimulation. There I go, geeking out again.

Dr. Tarbox: But sources of stress and distress in your life. Give yourself permission to take a small break and see if you can build a habit of that. Maybe one teeny thing. What if it's five minutes that you did per day? That is only for yourself for being kind and nurturing to yourself. That does not have to take away from taking care of your kid and your family. Find five minutes per day. That's only for yourself. Even if it's literally just sitting there with your eyes closed, paying attention to your breath, even if it's a five-minute walk around the block, we can all do it. It's not a privilege to be able to take care of yourself for five minutes a day. It is possible even under the most difficult circumstances.

Mary: It's just. I agree. I totally agree. OK. So we are need to wrap up soon. I did want to mention that, Jonathan, as well as Thomas Sabot. Yeah. Mm hmm. OK. And Megan Echlin just published recently an article, Acceptance and Commitment Training within the Scope Practice Applied to even analysis. We will link this in the show notes as well as anything else we mentioned. So we'll link that in the show notes and any other resources for, you know, parents or we didn't even get to talk to using ACT for kids with higher language abilities. But maybe I can have you back on in sometime in the future. But where can they learn more about act?

Dr. Tarbox: Yeah. Great. So I think the best thing you can do if you're a parent or if you're not if you're professional or if you're both is to get one or two of these ACT self-help books and just read them and actually do the exercises, just sort of power through the cheesiness of it, like, oh, great, I saw another self-help book. Just do it, just do the behaviors. And what you'll see is you'll see small changes that are awesome. So the first one you should check out is called The Reality Slap by Russ Harris is one of the world's top ACT trainers. And he also happened to have a child with autism after he was way back.

Dr. Tarbox: So I didn't realize that. Yeah. And so he uses his own experience, The Happiness Draft. Yeah. And The Reality Slap and The Confidence Gap. They. All right. But The Reality Slap, check it out. The Reality Slap. It's written from the standpoint of a parent of a child with autism, but it walks you through all the strategies and it does change your life. If you just practice these new habits in small ways, but consistently. So that's the first stop, definitely for parents. And then also for anybody. Steve Hayes new book called The Liberated Mind How to Pivot towards what Matters is a bestseller on Amazon or whatever, and it's written for the general public and totally readable. Totally consumable.

Dr. Tarbox: Again, if you actuallyjust do what the book suggests, like practice in multiple different ways, on multiple occasions, you'll notice your own behavior start to change and meaningful and awesome ways. So definitely recommend that for folks who are interested in act approaches for kids on the spectrum. There is the AIM curriculum by Mark Dixon and Dana Palla Lunas. And it stands for accept, identify, move. And it's an ABA ACT mindfulness curriculum. And it's very, very consumable by parents too, not just for professionals, it's for teachers and parents. And then also my wife, Courtney Tarbox, just published an article on Act for Kids on the Spectrum during the COVID pandemic. So some strategies for helping kids cope with some of these crazy new reality.

Dr. Tarbox: And so that's available in the Journal of Behavior Analysis and Practice. Or you can just email her at I'm sure she won't mind me sharing her email, [email protected] she'll send you a free copy of the PDF. And that's an important thing for parents to know and practitioners. If folks don't know it, if you want to research article and you don't have access because you're not at a university library, it's very easy to find the corresponding authors. The email address for free on the Journal's Web page and just click the little button that says Contact or just type in the email address. Just say, hey, can I have a PDF of your article? And they will always just send you a free PDF. You don't need to buy the journal subscription or the individual article. Just do it. You'll feel scared. Sending an e-mail to some hot shot that you've never talked to before. And that's fine. That's a good scare. Just do it and it works. They're happy to share their research.

Mary: That's excellent. I love those. And those will all be in the show notes as well. So this has been really fascinating. I definitely love talking to you. And and I might reach out to your wife to have her on the show as well. Yeah. So part of my podcast goal is for parents and professionals to be less stressed and lead happier lives. The whole episode was all about that. But just to sum up, like your own personal self-care or stress reduction strategies, just two or three that help you?

Dr. Tarbox: Yeah. So my biggest one for sure is practicing that present moment attention stuff that we were talking about before. And it's really just being fully present when I'm doing stuff that I really care about. And really for me that's pretty simple. The stuff I care about the most is spending precious moments with my kids. And so I have five and eight year old daughters. And so my commitment to myself and this is yeah, it's being a good dad. But it's really self care for me is my commitment to myself is when I'm with my daughters and with my daughters. And I'm not anywhere else. I'm not looking at my phone. I'm not on my laptop. I'm not doing the crazy multitasking culture that we've all somehow just not consented to and we're all a part of. That's not happening.

Dr. Tarbox: My choice is, that's a boundary when I'm engaged with my daughters. That's what I'm doing. I'm not doing anything else. Doesn't mean I don't sometimes tell them, look, I got to work, Daddy's got to get on the laptop. This is work time right now. But when it's not worked, the laptop's closed. iPad, you know, all that stuff's gone. I'm fully there and I practice doing it by zooming in. And I can see a freckle. There's a cute little eyelash and zoom out and I could see their whole body and it being so cute and wonderful and we can put 'em on your lap and just feel the warm, squishy awesomeness of their bodies and their clothes, their hair. Just fully tuned in to the experience in the moment.

Dr. Tarbox: And if you're thinking of that as like a guilt thing, I got to be more present. So I'm not like a bad mom or something, not self-care. But if you're doing it as a gift to yourself, like, what can I experience in a more profound way right now by being fully present with my kids? That's self-care. That's an act of self-care. And the cool thing is it's free. It's available to anybody at any time. You don't have to buy a book. You don't have to attend to webinar or anything else. You just practice it.

Mary: Well, I think that's an excellent way to end again. Thank you so much for spending some time with me and your listeners, and I'm sure that people will get a good deal out of this episode. So thank you.

Dr. Tarbox: Well, thanks a lot, Mary. I really appreciate the opportunity. And I appreciate what you do for the community, especially the community. It's really, really important work. So thank you.