Helping Couples Connect during the COVID-19 Pandemic: A Pilot Randomised Controlled Trial of an Awareness, Courage, and Love Intervention.

BACKGROUND: A second pandemic of mental health problems due to COVID-19 is predicted, suggesting a demand for interventions to mitigate its impacts. This study evaluated the effectiveness of an online psychological intervention based on the Awareness, Courage, and Love (ACL) model from Functional Analytic Psychotherapy to promote closeness between couples during the pandemic. METHOD: Thirty-one couples were randomised into either the intervention or control group for a 2-hour online group session. The intervention was designed to increase closeness between couples, whereas control group members watched a movie. In both groups, participants responded to two instruments that assessed the couple's relationship. Generalised linear mixed modeling was used to compare the change scores over time between the groups, with random effects used to control for the correlation within a couple and the correlation within the individual. RESULTS: The intervention group's closeness increased by 23 per cent while the control group's closeness increased only 2 per cent. A week later, a significant difference between the two groups emerged on closeness. CONCLUSION: Online ACL protocols requiring minimal training offer a promising intervention to quickly buffer against stress for large numbers of individuals during pandemic times.

Creating safe, evocative, attuned, and mutually vulnerable therapeutic beginnings: Strategies from functional analytic psychotherapy.

Functional analytic psychotherapy (FAP), with its emphasis on the creation of a safe, evocative, attuned, authentic, and mutually vulnerable therapeutic relationship, offers strategies that are especially relevant for therapeutic beginnings that yield an engaging and potent treatment. The 5 rules of FAP provide behavioral specificity in the early tasks of therapy that can build a powerful alliance with clients: creating trust and safety, moving the conversation from content to in-the-moment process, evoking and naturally reinforcing client target behaviors related to authentic expression, instilling hope, being aware of clinical impact, and promoting generalization of in-session gains to daily life. It is hoped that FAP offers a conceptually clear and inspiring transtheoretical framework that sets the stage for a deeply meaningful and unforgettable therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Using the primary process emotional-behavioural system to better meet patient needs in psychotherapy.

In order to increase therapeutic impact by enhancing awareness of clients' nonverbal communications, this article operationalizes the therapeutic alliance as a needs-satisfaction process. The client's competence as a needs seeker and the therapist assisting with the client's expression and satiation of basic social needs are proposed as being key mechanisms of change. Functional model of primary emotions derived from Panksepp's seven primary emotional systems (care seeking, caretaking, lust, fear and anxiety, anger, play, seeking, plus dominance and disgust) is integrated with Functional Analytic Psychotherapy's emphasis on in-session contingent natural reinforcement of clients' target behaviours. By identifying in-the-moment cues of underlying emotional-behavioural functions drawn from a categorization of clients' nonverbal communication can bridge the gap between client private events and therapist observables, in order to maximize therapist attunement and responsiveness to clients, and to increase the effectiveness of clinical interventions.

Saying good goodbyes to your clients: A functional analytic psychotherapy (FAP) perspective.

Functional analytic psychotherapy (FAP) promotes client growth by shaping clients' daily life problems that also show up in session with their therapists. FAP therapists create evocative contexts within therapy that afford clients the opportunity to practice, refine, and be reinforced for new, more adaptive behaviors which then can be generalized into their outside lives. In FAP, the termination process will vary from client to client depending on the nature of the client's problems and targets. For many clients, the process can be a rich, multifaceted, final opportunity to evoke, reinforce, and promote generalization of clients' in-session improvements, particularly improvements related to vulnerable self-expression in the service of intimate and close relationships. By making explicit agreements at the outset of therapy to participate in an intentional termination process, and by later providing an evocative structure for ending therapy with vulnerable emotional expression, clients have the opportunity to develop more adaptive behaviors in the context of relationship endings which can be a painful part of the human experience. Equipped with the skills of open-hearted communication developed from an authentic relationship with their therapist, clients can leave therapy on a trajectory of further growth in interpersonal connection and living more boldly. (PsycINFO Database Record

Introduction to using structured evocative activities in Functional Analytic Psychotherapy.

Functional Analytic Psychotherapy (FAP) focuses on what happens in session between clients and therapists in order to create more intense and curative therapeutic relationships. FAP may be used as a standalone treatment or as an adjunct to other therapies in order to maximize therapeutic gains through strengthened alliance and differential reinforcement. When it fits within a client's case conceptualization, FAP clinicians often choose to use structured, evocative activities to progress the therapy at a faster pace. This article provides a rationale for using structured evocative activities in FAP with concrete examples to facilitate clinicians' implementation of the exercises.

Reducing inadvertent clinical errors: Guidelines from functional analytic psychotherapy.

Two common types of clinical errors, inadvertently reinforcing client problem behaviors or inadvertently punishing client improvements, are conceptualized from the viewpoint of Functional Analytic Psychotherapy (FAP), a treatment that harnesses the power of the therapeutic relationship. Understanding the functions of client behaviors such as incessant talking and over compliance can lead to more compassionate and effective intervention, and a functional analysis of seemingly problematic behaviors such as silence and lack of cooperation indicate how they may be client improvements. Suggestions are provided for how to more accurately conceptualize whether client behaviors are problems or improvements, and to increase awareness of therapist vulnerabilities that can lead to errors. While FAP is rooted in a functional contextual philosophy, the goal of this article is to offer a framework that crosses theoretical boundaries to decrease the likelihood of clinical errors and to facilitate client growth. (PsycINFO Database Record

Functional analytic psychotherapy: a behavioral relational approach to treatment.

Functional analytic psychotherapy (FAP) is a relational approach to psychotherapy that is behavioral, yet involves an intensive, emotional, and in-depth therapy experience. FAP is approachable by therapists of diverse theoretical backgrounds owing to the minimal use of behavioral jargon, and can be used as an addition or complement to other interventions. The methods described in this article-being aware of clients' clinically relevant behaviors, being courageous in evoking clinically relevant behaviors, reinforcing improvements with therapeutic love, using behavioral interpretations to help clients generalize changes to daily life, and providing intensive and personal experiential training of FAP practitioners-maximize the impact of the therapeutic relationship to promote change and personal growth for both clients and therapists.

The use of awareness, courage, therapeutic love, and behavioral interpretation in Functional Analytic Psychotherapy.

Interventions from Functional Analytic Psychotherapy focus on what happens in-session between clients and therapists to create more intense and curative therapeutic relationships. The methods described--being aware of clients' clinically relevant behaviors, being courageous in evoking clinically relevant behaviors, reinforcing improvements with therapeutic love, and using behavioral interpretations to help clients generalize changes to daily life--point to compelling directions in personal growth and change for both clients and therapists.

Preliminary data from a randomized pilot study of web-based functional analytic psychotherapy therapist training.

Therapists of many persuasions emphasize the therapy relationship in their work, a priority backed by strong empirical evidence. Training in how to maximize the power and potential of the therapy relationship, however, has lagged behind. A novel approach to using the therapy relationship and to training therapists in its use is provided by Functional Analytic Psychotherapy (FAP). FAP training involves eight 2-hr weekly training sessions conducted online using web-conferencing technology. The training integrates behavioral principles with a focus on trainee-trainer and trainee-trainee relationships in a highly structured course that evokes the desirable FAP therapist-trainee behaviors and collectively shapes the behaviors through reinforcement by the trainer and other trainees. In a preliminary study, 16 therapist-trainees were randomly assigned to receive either immediate FAP training or training after a waitlist period. Significant and large effects of training were found on both self-reported and observer-assessed measures for the first training group, and the waitlist training group replicated the first training group with significant within-subject change over the course of training. Finally, qualitative feedback from therapists indicated high satisfaction with the primary elements of the training protocol. Several important limitations to this preliminary study are discussed.

Therapeutic Change Processes in Functional Analytic Psychotherapy

This paper discusses the mechanism of change and therapeutic techniques central to Functional Analytic Psychotherapy (FAP). Based on the experimental analysis of behavior, contingencies of reinforcement are viewed as an important mechanism of change leading to significant therapeutic improvements. The issue addressed in this paper concerns how a therapist can make maximum use of contingencies of reinforcement, given that the client´s problems occur in daily life. FAP emphasizes the client-therapist relationship as providing opportunities for the immediate shaping and reinforcement of improved behavior. The principles of functional analysis are used to explain how actual instances of daily life problems can occur during the session, providing opportunities for therapeutic change, and then mediating generalization from improvements during the session to daily life. Central concepts discussed in this paper include: clinically relevant behavior (CRB), natural reinforcement, interpersonal processes, the behavioral implications of an intense and emotional therapistclient relationship, private behavior, cognitions as behavior, and the behavioral analysis of language (verbal behavior). Five rules that guide therapists in facilitating intense and transformative work with their clients are also discussed (AU)

En este artículo se aborda el mecanismo de cambio y las técnicas terapéuticas que son centrales a la Psicoterapia Analítica Funcional (PAF). El análisis experimental de las conductas ha hecho que se consideren a las contingencias de reforzamiento como un mecanismo importante para el cambio que puede llegar a llevar a mejoras terapéuticas significativas. En este articulo nos centramos en cómo un terapeuta puede maximizar su uso de las contingencias de reforzamiento, dado que los problemas del paciente surgen en su día a día. La PAF hace hincapié en la relación cliente-terapeuta como una oportunidad para moldear y reforzar unas conductas mejoradas. Se emplean los principios del análisis funcional para explicar cómo se pueden dar, durante la sesión, ejemplos reales de los problemas cotidianos del paciente, dándose así oportunidades para lograr el cambio terapéutico y para generalizar estas mejoras desde la sesión hacia el día a día del paciente. Algunos conceptos centrales que se tratan en este artículo son: la conducta clínicamente relevante, el reforzamiento natural, los procesos interpersonales, las implicaciones para la conducta de una relación terapeuta-cliente intensa, la conducta privada, las cogniciones de la conducta, y el análisis conductual del lenguaje (conducta verbal). También se presentan 5 reglas para facilitar un trabajo intenso y transformador de los terapeutas con sus clientes (AU)