Elsevier

Behavior Therapy

Volume 44, Issue 2, June 2013, Pages 180-198
Behavior Therapy

TARGET ARTICLE
Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy

https://doi.org/10.1016/j.beth.2009.08.002Get rights and content

Abstract

A number of recent authors have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (CBT). The present article describes ACT as a distinct and unified model of behavior change, linked to a specific strategy of scientific development, which we term “contextual behavioral science.” We outline the empirical progress of ACT and describe its distinctive development strategy. A contextual behavioral science approach is an inductive attempt to build more adequate psychological systems based on philosophical clarity; the development of basic principles and theories; the development of applied theories linked to basic ones; techniques and components linked to these processes and principles; measurement of theoretically key processes; an emphasis on mediation and moderation in the analysis of applied impact; an interest in effectiveness, dissemination, and training; empirical testing of the research program across a broad range of areas and levels of analysis; and the creation of a more effective scientific and clinical community. We argue that this is a reasonable approach, focused on long-term progress, and that in broad terms it seems to be working. ACT is not hostile to traditional CBT, and is not directly buoyed by whatever weaknesses traditional CBT may have. ACT should be measured at least in part against its own goals as specified by its own developmental strategy.

Highlights

► ACT is following a distinct contextual behavioral science (CBS) development strategy. ► The ACT/RFT model, its core features, and relevant research are described. ► The CBS strategy seems to be reasonably progressive. ► ACT should be evaluated, in part, based on its own scientific strategy and goals. ► The field should examine the progressivity of the scientific strategies it uses.

Section snippets

The CBT Tradition and the Origins of Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT, said as one word, not initials; Hayes, Strosahl, & Wilson, 1999) is sometimes placed outside of or opposed to CBT (e.g., Hofmann & Asmundson, 2008), but ACT is part of the larger family of behavioral and cognitive therapies (Forman & Herbert, 2009) and has always been said to be so (e.g., Hayes, Strosahl, et al., 1999, p. 79). ACT is an overarching model of key intervention and change processes, linked to a research program on the nature of language and

ACT: A CBS Approach

CBS is a principle-focused, inductive strategy of psychological system building that emphasizes developing interventions based on theoretical models tightly linked to basic principles that are themselves constantly upgraded and evaluated. The strategy has been abstracted and extended from traditional behavior analysis. Only an outline can be presented here because the issues it raises (e.g., induction vs. deduction, pragmatic vs. correspondence theories of truth, the nature of theory) are

The Scientific Development Strategy of Empirical Clinical Psychology

Empirical clinical psychology needs to attend more to its development strategy. In the usual approach, philosophical assumptions are not explicated, basic processes are all too often an afterthought, and if they exist at all theories are generally narrowly focused, vague, expressed in commonsense terms, and at times wholy untested. The idea seems to be that the Food and Drug Administration (FDA) style of medication validation can be used to build a progressive field based on manualized

Conclusion

The scientific progress of empirical clinical psychology seems mixed—no one claims that either paradise or failure has been achieved. Some see the glass as half full and say that the dominant strategy is working; others see it half empty and lobby for strategic change. Frankly, that argument will not be decided by established researchers—it will be decided sociologically by junior researchers, theorists, and students choosing where to invest their life energy.

It seems clear that the field is

References (102)

  • B.A. Marcks et al.

    Role of thought-related beliefs and coping strategies in the escalation of intrusive thoughts: An analog to obsessive-compulsive disorder

    Behaviour Research and Therapy

    (2007)
  • A. Masuda et al.

    The impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders

    Behaviour Research and Therapy

    (2007)
  • A. Masuda et al.

    Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique

    Behaviour Research and Therapy

    (2004)
  • L.M. McCracken et al.

    Acceptance of chronic pain: Component analysis and a revised assessment method

    Pain

    (2004)
  • J. McMullen et al.

    Acceptance versus distraction: Brief instructions, metaphors, and exercises in increasing tolerance for self-delivered electric shocks

    Behaviour Research and Therapy

    (2008)
  • M.T. Moore et al.

    The relationship of explanatory flexibility to explanatory style

    Behavior Therapy

    (2007)
  • L.G. Öst

    Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis

    Behaviour Research and Therapy

    (2008)
  • M. Páez-Blarrina et al.

    The role of values with personal examples in altering the functions of pain: Comparison between acceptance-based and cognitive-control-based protocols

    Behaviour Research and Therapy

    (2008)
  • I. Rosenfarb et al.

    Social standard setting: The Achilles' heel of informational accounts of therapeutic change

    Behavior Therapy

    (1984)
  • M.P. Twohig et al.

    Increasing willingness to experience obsessions: Acceptance and commitment therapy as a treatment for obsessive compulsive disorder

    Behavior Therapy

    (2006)
  • R.K. Wicksell et al.

    Development and preliminary validation of the Psychological Inflexibility in Pain Scale (PIPS)

    European Journal of Pain

    (2008)
  • R.D. Zettle et al.

    The conceptual and empirical status of rational-emotive therapy

  • R.D. Zettle et al.

    Rule-governed behavior: A potential theoretical framework for cognitive-behavior therapy

  • J.J. Arch et al.

    Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?

    Clinical Psychology, Science and Practice

    (2008)
  • P. Bach et al.

    The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial

    Journal of Consulting and Clinical Psychology

    (2002)
  • R.A. Baer et al.

    Assessment of mindfulness by self-report: The Kentucky Inventory of Mindfulness Skills

    Assessment

    (2004)
  • R.A. Baer et al.

    Using self-report assessment methods to explore facets of mindfulness

    Assessment

    (2006)
  • R.F. Baumeister et al.

    How emotions facilitate and impair self-regulation

  • A.T. Beck

    Cognitive therapy: Past, present, and future

    Journal of Consulting and Clinical Psychology

    (1993)
  • N.M. Berens et al.

    Arbitrarily applicable comparative relations: Experimental evidence for a relational operant

    Journal of Applied Behavior Analysis

    (2007)
  • G.A. Bonanno et al.

    The importance of being flexible: The ability to both enhance and suppress emotional expression predicts long-term adjustment

    Psychological Science

    (2004)
  • R.A. Brown et al.

    Distress tolerance and duration of past smoking cessation attempts

    Journal of Abnormal Psychology

    (2002)
  • N. Chawla et al.

    Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review

    Journal of Clinical Psychology

    (2007)
  • D. Cioffi et al.

    Delayed costs of suppressed pain

    Journal of Personality and Social Psychology

    (1993)
  • D.A. Clark

    Perceived limitations of standard cognitive therapy: A reconsideration of efforts to revise Beck's theory and therapy

    Journal of Cognitive Psychotherapy

    (1995)
  • G.L. Cohen et al.

    Reducing the racial achievement gap: A social-psychological intervention

    Science

    (2006)
  • J.D. Creswell et al.

    Affirmation of personal values buffers neuroendocrine and psychological stress responses

    Psychological Science

    (2005)
  • M.J. Dougher et al.

    Transformation of the discriminative and eliciting functions of generalized relational stimuli

    Journal of the Experimental Analysis of Behavior

    (2007)
  • M.J. Dugas et al.

    Intolerance of uncertainty and problem orientation in worry

    Cognitive Therapy and Research

    (1997)
  • S. Folkman et al.

    Appraisal, coping, health status, and psychological symptoms

    Journal of Personality and Social Psychology

    (1986)
  • W.C. Follette

    Correcting methodological weaknesses in the knowledge base used to derive practice standards

  • E.M. Forman et al.

    New directions in cognitive behavior therapy: Acceptance-based therapies

  • E.M. Forman et al.

    A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression

    Behavior Modification.

    (2007)
  • M.A. Friedman et al.

    A comprehensive treatment manual for the management of obesity

  • J.A. Gregg et al.

    Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial

    Journal of Consulting and Clinical Psychology

    (2007)
  • O. Gutiérrez et al.

    Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain

    Behavior Therapy

    (2004)
  • P.R. Harris et al.

    Self-affirmation and the biased processing of threatening health-risk information

    Personality and Social Psychology Bulletin

    (2005)
  • S.C. Hayes

    Making sense of spirituality

    Behaviorism

    (1984)
  • S.C. Hayes

    A contextual approach to therapeutic change

  • S.C. Hayes

    Rule-governed behavior: Cognition, contingencies, and instructional control

    (1989)

    • Cited by (0)

    View full text
    Copyright © 2011 Published by Elsevier Ltd.