Stability and change in cognitive behavior therapy: Considering the implications of ACT and RFT

ABSTRACT: Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) are part of the new wave of treatments and analyses that seem to be emerging in cognitive behavior therapy. In this article, data in support of these new approaches are provided, and evidence that ACT works through different processes than traditional CBT are presented. The integrative proposals of Ciarrochi and Robb, and Ciarrochi, Robb, and Godsell are then considered. In the long run, whether such integrations are useful is an empirical matter, but concerns are raised about the effects of focusing on the content of beliefs, and the role of logical-empirical challenges to belief. KEY WORDS: acceptance and commitment therapy; relational frame theory; functional contextualism; third wave behavior therapy; rational-emotive behavior therapy. Change is built into all scientific fields, and should be neither surprising nor threatening. Change should never be for change's sake, however. In empirical clinical psychology, change should be driven by advancements in theory, technology, and demonstrated impact on the behavioral health problems. Over the past several years it is undeniable that change has arrived in the behavioral and cognitive therapies. A variety of techniques have arisen that do not fit easily into preexisting categories. These include such treatments as Dialectica

Fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso

This article has two main purposes. The first one is to present the philosophical, theoretical, and empirical underpinnings of Acceptance and Commitment Therapy (ACT). The second is to outline the importance of philosophy and theory in order to build an empirical clinical psychology that copes progressively with the needs of the field. To accomplish these purposes, we have structured the article in three distinct sections. In the first one, we will explore the philosophical assumptions of ACT, known as Functional Contextualism. In the second section, we will offer a brief history of the appliedand theoretical tradition of ACT, Behavior Analysis, and Relational Frame Theory (RFT), a modern account of human language and cognition. Finally, we will present some clinical outcomes that, although preliminary, exemplify the broad range of health problems and psychological disorders for which the ACT model has shown to have positive results. Overall we will offer a unified version of the ACT/RFT model that interconnects its multiple dimensions.El presente artículo cumple dos propósitos. En primer lugar presentar los fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso (TAC), y, en segundo lugar, argumentar cuán importante es la filosofía y la teoría de cara a construir una psicología clínica empírica que afronte de un modo progresivo las necesidades del campo. Para cumplir estos propósitos, hemos estructurado el artículo en tres secciones. En la primera exploramos los presupuestos filosóficos de la TAC, el llamado Contextualismo Funcional. En la segunda sección ofrecemos una breve historia de la tradición aplicada y teórica de la TAC, esto es, el Análisis de Conducta, y acontinuación ofrecemos una aproximación moderna al lenguaje y la cognición, la Teoría de los Marcos Relacionales (TMR). Finalmente, presentamos una serie de estudios empíricos que ejemplifican de modo preliminar el amplio rango de problemas psicológicos y de la salud para los que la TAC ha mostrado resultados positivos. En conjunto, este artículo ofrece una versión unificada del modelo de la TAC/TMR que interconecta sus múltiples dimensiones

Fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso

This article has two main purposes. The first one is to present the philosophical, theoretical, and empirical underpinnings of Acceptance and Commitment Therapy (ACT). The second is to outline the importance of philosophy and theory in order to build an empirical clinical psychology that copes progressively with the needs of the field. To accomplish these purposes, we have structured the article in three distinct sections. In the first one, we will explore the philosophical assumptions of ACT, known as Functional Contextualism. In the second section, we will offer a brief history of the appliedand theoretical tradition of ACT, Behavior Analysis, and Relational Frame Theory (RFT), a modern account of human language and cognition. Finally, we will present some clinical outcomes that, although preliminary, exemplify the broad range of health problems and psychological disorders for which the ACT model has shown to have positive results. Overall we will offer a unified version of the ACT/RFT model that interconnects its multiple dimensions.El presente artículo cumple dos propósitos. En primer lugar presentar los fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso (TAC), y, en segundo lugar, argumentar cuán importante es la filosofía y la teoría de cara a construir una psicología clínica empírica que afronte de un modo progresivo las necesidades del campo. Para cumplir estos propósitos, hemos estructurado el artículo en tres secciones. En la primera exploramos los presupuestos filosóficos de la TAC, el llamado Contextualismo Funcional. En la segunda sección ofrecemos una breve historia de la tradición aplicada y teórica de la TAC, esto es, el Análisis de Conducta, y acontinuación ofrecemos una aproximación moderna al lenguaje y la cognición, la Teoría de los Marcos Relacionales (TMR). Finalmente, presentamos una serie de estudios empíricos que ejemplifican de modo preliminar el amplio rango de problemas psicológicos y de la salud para los que la TAC ha mostrado resultados positivos. En conjunto, este artículo ofrece una versión unificada del modelo de la TAC/TMR que interconecta sus múltiples dimensiones

A Relational Frame Training Intervention to Raise Intelligence Quotients: A Pilot Study

The current research consisted of 2 studies designed to test the effectiveness of automated multiple-exemplar relational training in raising children’s general intellectual skills. In Study 1, 4 participants were exposed to multiple exemplar training in stimulus equivalence and the relational frames of SAME, OPPOSITE, MORE THAN, and LESS THAN across several sessions and weeks. WISC (III-UK) measures were taken at baseline, following stimulus equivalence training, and again following relational frame training. Matched against a no-treatment control group, experimental participants showed significant improvements in full-scale IQ following stimulus equivalence training, and a further significant rise following relational frame training. Study 2 administered an improved multiple-exemplar-based relational frame training intervention to 8 children with a range of educational and behavioral difficulties. In 7 of the 8 cases, full-scale IQ as measured by the WISC (IV-UK) rose by at least 1 SD; the improvement was statistically significant at the group level. These data have important implications for the behavioral analysis of intellectual skills and suggest the basis of an intervention to improve general cognitive functioning

A Relational Frame Training Intervention to Raise Intelligence Quotients: A Pilot Study

The current research consisted of 2 studies designed to test the effectiveness of automated multiple-exemplar relational training in raising children’s general intellectual skills. In Study 1, 4 participants were exposed to multiple exemplar training in stimulus equivalence and the relational frames of SAME, OPPOSITE, MORE THAN, and LESS THAN across several sessions and weeks. WISC (III-UK) measures were taken at baseline, following stimulus equivalence training, and again following relational frame training. Matched against a no-treatment control group, experimental participants showed significant improvements in full-scale IQ following stimulus equivalence training, and a further significant rise following relational frame training. Study 2 administered an improved multiple-exemplar-based relational frame training intervention to 8 children with a range of educational and behavioral difficulties. In 7 of the 8 cases, full-scale IQ as measured by the WISC (IV-UK) rose by at least 1 SD; the improvement was statistically significant at the group level. These data have important implications for the behavioral analysis of intellectual skills and suggest the basis of an intervention to improve general cognitive functioning

Walmart Impact on the Finance and Insurance Industry

Purpose This paper investigates the effect of Walmart presence on professional service firms within the finance and insurance sector. This paper also discusses the finance and insurance industry’s place within the Walmart ripple effect—changed retail sector leads to changed professional support services resulting in altered levels of social capital within the community. Design/Methodology The study uses county-level data from the state of Nebraska to examine the relationship between cumulative Walmart exposure and the number of firms, number of employees, and payroll levels within the finance and insurance (F&I) sector. These same variables are also investigated within two specific F&I industries—insurance and banking. Findings The study documents a negative association between cumulative Walmart presence and the number of employees in the finance and insurance industry and a positive relationship between Walmart exposure and F&I payroll levels. The insurance industry results are consistent with the F&I sector result relating to payroll, but show a significant positive relationship between cumulative Walmart exposure and number of insurance agencies. Empirical results from the commercial banking industry are consistent with both the F&I sector and insurance industries with a positive relationship between Walmart presence over time and payroll levels. Originality/value This study contributes to the Walmart effect literature by considering the impact of Walmart presence beyond the retail sector. The paper investigates the effect of Walmart on the finance and insurance profession, a sector that 1) competes directly with Walmart Supercenters for money services, 2) provides support services for retail businesses impacted by Walmart services, and 3) potentially suffers from centralized benefits provided to employees by Walmart headquarters rather than local insurers. The paper concludes that the mixed impact on professional firms results in social capital that could be both strengthened and challenged by Walmart presence

The idionomic future of cognitive behavioral therapy : What stands out from criticisms of ACT development

The present special section critical of Acceptance and Commitment Therapy or Training (ACT in either case) and its basis in psychological flexibility, relational frame theory, functional contextualism, and contextual behavioral science (CBS) contains both worthwhile criticisms and fundamental misunderstandings. Noting the important historical role that behavior analysis has played in the cognitive behavioral therapy (CBT) tradition, we argue that CBS as a modern face of behavior analytic thinking has a potentially important positive role to play in CBT going forward. We clarify functional contextualism and its link to ethical behavior, attempting to clear up misunderstandings that could seriously undermine genuine scientific conversations. We then examine the limits of using syndromes and protocols as a basis for further developing models and methods; the role of measurement and processes of change in driving progress toward more personalized interventions; how pragmatically useful concepts can help basic science inform practice; how both small- and large-scale studies can contribute to scientific progress; and how all these strands can be pulled together to benefit humanity. In each area, we argue that further progress will require major modifications in our traditional approaches to such areas as psychometrics, the conduct of randomized trials, the analysis of findings using traditional normative statistics, and the use of data from diverse cultures and marginalized populations. There have been multiple generational shifts in our field's history, and a similar shift appears to be taking place once again

The role of the individual in the coming era of process-based therapy

For decades the development of evidence-based therapy has been based on experimental tests of protocols designed to impact psychiatric syndromes. As this paradigm weakens, a more process-based therapy approach is rising in its place, focused on how to best target and change core biopsychosocial processes in specific situations for given goals with given clients. This is an inherently more idiographic question than has normally been at issue in evidence-based therapy over the last few decades. In this article we explore methods of assessment and analysis that can integrate idiographic and nomothetic approaches in a process-based era.Accepted manuscrip

Toward a unified framework for positive psychology interventions : Evidence-based processes of change in coaching, prevention, and training

Since 2000, research within positive psychology has exploded, as reflected in dozens of meta-analyses of different interventions and targeted processes, including strength spotting, positive affect, meaning in life, mindfulness, gratitude, hope, and passion. Frequently, researchers treat positive psychology processes of change as distinct from each other and unrelated to processes in clinical psychology. This paper presents a comprehensive framework for positive psychology processes that crosses theoretical orientation, links coherently to clinical psychology and its more dominantly “negative” processes, and supports practitioners in their efforts to personalize positive psychological interventions. We argue that a multi-dimensional and multi-level extended evolutionary approach can organize effective processes of change in psychosocial interventions, by focusing interventions on context-appropriate variation, selection, and retention of processes, arranged in terms of key biopsychosocial dimensions across psychological, biophysiological, and sociocultural levels of analysis. We review widely studied positive psychology constructs and programs and show how this evolutionary approach can readily accommodate them and provide a common language and framework for improving human and community flourishing.We conclude that Interventions should with the person, not the protocol