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.

Functional contextual implementation of an evolutionary, entropy-based, and embodied free energy framework: Utilizing Lagrangian mechanics and evolutionary game theory's truth vs. fitness test of the veridicality of phenomenological experience.

The Bayesian approach of cognitive science largely takes the position that evolution drives perception to produce precepts that are veridical. However, some efforts utilizing evolutionary game theory simulations have shown that perception is more likely based on a fitness function, which promotes survival rather than promoting perceptual truth about the environment. Although these findings do not correspond well with the standard Bayesian approach to cognition, they may correspond with a behavioral functional contextual approach that is ontologically neutral (a-ontological). This approach, formalized through a post-Skinnerian account of behaviorism called relational frame theory (RFT), can, in fact, be shown to correspond well with an evolutionary fitness function, whereby contextual functions form that corresponds to a fitness function interface of the world. This fitness interface approach therefore may help provide a mathematical description for a functional contextual interface of phenomenological experience. Furthermore, this more broadly fits with a neurological active inference approach based on the free-energy principle (FEP) and more broadly with Lagrangian mechanics. These assumptions of how fitness beats truth (FBT) and FEP correspond to RFT are then discussed within a broader multidimensional and evolutionary framework called the extended evolutionary meta-model (EEMM) that has emerged out of the functional contextual behavioral science literature to incorporate principles of cognition, neurobiology, behaviorism, and evolution and are discussed in the context of a novel RFT framework called "Neurobiological and Natural Selection Relational Frame Theory" (N-frame). This framework mathematically connects RFT to FBT, FEP, and EEMM within a single framework that expands into dynamic graph networking. This is then discussed for its implications of empirical work at the non-ergodic process-based idiographic level as applied to individual and societal level dynamic modeling and clinical work. This discussion is framed within the context of individuals that are described as evolutionary adaptive and conscious (observer-self) agents that minimize entropy and can promote a prosocial society through group-level values and psychological flexibility.

Case Conceptualizing in Acceptance and Commitment Therapy for Moral Injury: An Active and Ongoing Approach to Understanding and Intervening on Moral Injury.

Acceptance and Commitment Therapy for Moral Injury (ACT-MI; 10-11), is an application of Acceptance and Commitment Therapy principles designed to help individuals live their values, even in the presence of moral pain. ACT-MI differs from other emerging treatments for moral injury in that ACT-MI is not based on a traditional syndromal approach to conceptualizing moral injury, which treats moral injury as a collection of signs and symptoms to be reduced. Rather than assuming moral injury causes suffering through a constellation of symptoms that a person has, in ACT-MI, moral injury is defined by what a person does in response to moral pain. Consistent with this framework, we present a unique approach to moral injury case conceptualization that emphasizes function over form, providing clients the opportunity to break free from the patterns of behavior that cause moral injury-related suffering to persist. Rooted in approaches to conceptualizing that have demonstrated utility in extant interventions (e.g., ACT), ACT-MI clinicians conduct ongoing functional analyses to inform case conceptualization and intervention. Functional analysis is used to disrupt the processes maintaining moral injury, as the client and therapist work to identify and intervene on the behaviors reinforcing avoidance and control of painful internal experiences causing moral injury. In the current article, we guide the reader through a framework for applying functional analysis to the conceptualization of moral injury where the reinforcers driving moral injury are explored. We also provide examples of questions that can be used to help uncover the functions of moral injury consistent behavior. Case examples based on our experiences treating moral injury are presented to demonstrate how various types of morally injurious events can evoke different features of moral pain which in turn motivate different repertoires of avoidance and control. These inflexible patterns of avoidance and control create suffering by engaging in behavior designed to escape moral pain, such as social isolation, spiritual disconnection, reduced self-care, suicidal ideation, and substance use. We discuss how to target this suffering using functional analysis to guide treatment decisions, matching interventional processes within ACT-MI to the specific functions that moral injury-related behavior is serving for an individual. We suggest that the use of functional analytic case formulation procedures described herein can assist clients in disrupting behavioral patterns maintaining moral injury and thereby free them to pursue lives of greater meaning and purpose.

A Functional Contextual Account of Background Knowledge in Categorization: Implications for Artificial General Intelligence and Cognitive Accounts of General Knowledge.

Psychology has benefited from an enormous wealth of knowledge about processes of cognition in relation to how the brain organizes information. Within the categorization literature, this behavior is often explained through theories of memory construction called exemplar theory and prototype theory which are typically based on similarity or rule functions as explanations of how categories emerge. Although these theories work well at modeling highly controlled stimuli in laboratory settings, they often perform less well outside of these settings, such as explaining the emergence of background knowledge processes. In order to explain background knowledge, we present a non-similarity-based post-Skinnerian theory of human language called Relational Frame Theory (RFT) which is rooted in a philosophical world view called functional contextualism (FC). This theory offers a very different interpretation of how categories emerge through the functions of behavior and through contextual cues, which may be of some benefit to existing categorization theories. Specifically, RFT may be able to offer a novel explanation of how background knowledge arises, and we provide some mathematical considerations in order to identify a formal model. Finally, we discuss much of this work within the broader context of general semantic knowledge and artificial intelligence research.

A network analysis of two conceptual approaches to the etiology of PTSD.

Two prominent conceptual models of posttraumatic stress disorder (PTSD) are the cognitive model, associated with cognitive processing therapy (CPT; Resick & Schnicke, 1992), and the functional contextualist model, underlying acceptance and commitment therapy (ACT; Hayes et al., 1999). Network analysis was used to examine dynamic interactions among cognitive (relating to CPT) and functional contextualistic (relating to ACT) variables and PTSD symptoms in a sample of 722 trauma-exposed adults. Results from the cognitive networks highlighted the importance of maladaptive beliefs about threat in maintaining the co-occurrence of PTSD symptoms and cognitive variables. Additionally, PTSD symptoms were more likely to lead to cognitive variables, rather than the reverse direction. Results from the functional contextualist networks identified numerous associations amongst variables that contribute to the co-occurrence of PTSD symptoms and psychological inflexibility. Findings from this study may help generate causal hypotheses that can be tested further using a longitudinal study design.

Selection by consequence: A response to Hayes and Fryling (2019).

The paper by Hayes and Fryling (2019) seeks to inform readers that the Kantorian system of Interbehaviorism has been misunderstood and misrepresented by contextual behavior scientists. Furthermore, these authors suggest that much is to be gained by embracing the system developed by Kantor, most importantly that being large scale system building efforts. We disagree with this position, and find the Kantorian system to be of questionable relevancy and at risk of potential extinction within the behavioral community. We also have concerns that perhaps the insights provided by Hayes and Fryling will fail in recruitment of additional members to the Interbehavioral cause. Although the overarching theme of Interbehaviorism is present within emerging dynamical approaches to behavior science, adopting the vernacular of Kantor may be unnecessary to continue his tradition. We recommend allowing empirical selection to run its course in determining the eventual fate of Kantor's Interbehaviorism.

The untapped potential of behaviour analysis and interprofessional care.

Interprofessional collaboration has become a sought-after component of quality mental health care. Higher education institutions and mental health organizations seek to equip clinicians with the ability to provide cohesive clinical services while working collaboratively with a diverse group of professionals. Although research suggests that there may be benefits of interprofessional collaboration in mental health settings, collaborative practice initiatives have struggled with conceptual and methodological limitations. A behaviour analytic contribution to interprofessional care provides a philosophical position with an analytical goal distinguished by the prediction and influence of events, theoretical clarity, and methodological rigour that are needed within interprofessional research and practice. At the philosophical level, the extension of functional contextualism to interprofessional care research may provide a framework to achieve the valued ends of improving interprofessional collaboration and ultimately improving health-related outcomes for service users. Interprofessional collaboration can be conceptualized as metacontingency, a behaviour analytic concept that allows for a group level analysis of contributing social components. This paper uses the example of mental health care to guide a conceptual analysis of the potential application of behaviour analytic methodology within interprofessional practice, research, and education.

Mindfulness: ¿proceso, habilidad o estrategia? Un análisis desde el análisis del comportamiento y del contextualismo funcional / Mindfulness: processus, compétence ou stratégie ? Étude de l'analyse comportementale et du contextualisme fonctionnel / Mindfulness: processo, habilidade ou estratégia? Estudo a partir da análise comportamental e do contextualismo funcional / Mindfulness: process, skill or strategy? A behavioral-analytic and functional-contextualistic analysis

Los efectos positivos del mindfulness en el tratamiento de múltiples problemas psicológicos en diversas poblaciones han popularizado su uso dentro de la psicología clínica en los últimos años. No obstante, las investigaciones empíricas y revisiones teóricas sobre el mindfulness muestran tres usos diferentes del mindfulness dentro de las aproximaciones conductuales: como proceso, como habilidad y como estrategia. Las discrepancias en las definiciones de mindfulness han generado ambigüedad con respecto a qué y cómo se investiga este fenómeno. En este trabajo se realizó un análisis conceptual de las definiciones del mindfulness de acuerdo con los supuestos filosóficos analíticos-conductuales y contextualistas-funcionales. Finalmente, se discutió la importancia de contar con una definición precisa y unánime con el fin de desarrollar una agenda coordinada de investigación en esse campo.

Les effets positifs du mindfulness dans le traitement de plusieurs problèmes psychologiques dans différentes populations ont encouragé la psychologie clinique à l'utiliser au cours des dernières années. Cependant, la recherche théorique et empirique sur les examens de pleine conscience montrent trois utilisations différentes de l'attention dans les approches comportementales: comme un processus, comme une compétance et en tant que stratégie. Les divergences dans les définitions de la pleine conscience ont créé une ambiguïté quant à pourquoi et comment ce phénomène est étudié. Cet article est une analyse conceptuelle de la pleine conscience ayant comme paramètres philosophiques l'analyse du comportement et le contextualisme fonctionnel. La discussion finale tourne autour de l'importance d'avoir une définition précise et unanime en vue d'élaborer un programme coordonné de recherche dans ce domaine.

Os efeitos positivos do mindfulness no tratamento de vários problemas psicológicos em diferentes populações incentivaram a psicologia clínica a utilizá-lo nos últimos anos. No entanto, pesquisas empíricas e revisões teóricas sobre o mindfulness mostraram três usos diferentes desse termo segundo perspectivas comportamentais: como processo, como habilidade e como estratégia. As discrepâncias nas definições do mindfulness geraram ambiguidade em relação àquilo que é pesquisado e como é pesquisado. Neste texto, realizou-se uma análise conceitual das definições do mindfulness tendo como bases filosóficas a análise do comportamento e o contextualismo funcional. Por último, discutiu-se a importância de ter uma definição precisa e unânime com o objetivo de desenvolver uma agenda coordenada de pesquisa nesse campo.

Mindfulness has been widely disseminated in clinical psychology in recent years, due to the positive effects on treating several psychological issues in diverse population. Nonetheless, empirical research and theoretical reviews show three different meanings of mindfulness within behavioral approaches: as a process, as skill, and as a strategy. Discrepancies about mindfulness definitions have brought ambiguity to what and how this phenomenon is studied. A conceptual analysis of mindfulness according to behavioral-analytic and functional-contextualistic philosophical traditions is presented. Finally, it was discussed the relevance of employing a precise and consensual definition of mindfulness to develop a coordinated research agenda in this field.

Functional relations and cognitive psychology: Lessons from human performance and animal research.

We consider requirements for effective interdisciplinary communication and explore alternative interpretations of "building bridges between functional and cognitive psychology." If the bridges are intended to connect radical behaviourism and cognitive psychology, or functional contextualism and cognitive psychology, the efforts are unlikely to be successful. But if the bridges are intended to connect functional relationships and cognitive theory, no construction is needed because the bridges already exist within cognitive psychology. We use human performance and animal research to illustrate the latter point and to counter the claim that the functional approach is unique in offering a close relationship between science and practice. Effective communication will be enhanced and, indeed, may only occur if the goal of functional contextualism extends beyond just "the advancement of functional contextual cognitive and behavioral science and practice" to "the advancement of cognitive and behavioral science and practice" without restriction.

Terapia de aceitação e compromisso: história, fundamentos, modelo e evidências / Acceptance and commitment therapy: history, foundations,model and evidence

Este artigo tem o objetivo de realizar uma revisão histórica e conceitual da terapia de aceitação e compromisso (ACT). Esta é uma terapia cognitivo-comportamental baseada (a) no contextualismo funcional, filosofia que visa à predição e influência do comportamento com precisão, escopo e profundidade; e (b) na teoria dos quadros relacionais, uma abordagem pós-skinneriana da linguagem e da cognição. A ACT propõe um modelo de mudança do comportamento denominado flexibilidade psicológica, que explica o funcionamento saudável e psicopatológico por meio da interação de processos psicológicos normais. As evidências de efetividade e processo sinalizam que a ACT é um sistema terapêutico promissor, diretamente orientado para a identificação de mecanismos de mudança do comportamento humano.(AU)

The objective of this study is to present a historical and conceptual review of Acceptance and Commitment Therapy (ACT). It is a cognitive-behavioral therapy based (a) on functional contextualism, a philosophy aiming to predict and influence behavior with precision, scope, and depth, and (b) on relational frame theory, a post-skinnerian approach of language and cognition. ACT proposes a model of behavior change, psychological flexibility, which explains healthy and psychopathological functioning through interaction of normal psychological processes. Process and effectiveness research evidence signal that ACT is a promising therapeutic approach openly guided to identify human behavior mechanisms of change.(AU)

Dependencia afectiva: abordaje desde una perspectiva contextual / Affective dependence: an approach of contextual perspective

Resumen El artículo presenta una revisión teórica de la dependencia afectiva desde el punto de vista del análisis de la conducta y el contextualismo funcional. Se exponen algunos dilemas encontrados en la literatura sobre su relación con el apego y su conceptualización como un nuevo tipo de adicción. Posteriormente, se analizan las manifestaciones clínicas principales, enfocándose en las diferentes áreas de comportamiento, así como algunas de las habilidades básicas manifiestas en situaciones de interacción social y solución de problemas. Finalmente, se aborda una propuesta de intervención derivada de la terapia conductual contemporánea y las subsecuentes terapias de tercera generación.

Abstract The article presents a theoretical review of Affective dependence based on the analysis of behavior and the functional context. Describes some dilemmas found at the literature about their relationship with the attachment and their conceptualization as a new kind of addiction. Then, analyzes the main clinical manifestations in the different areas of behavior and some of basic skills that are manifested in social interaction situations and the capacity of solve problems. Finally, proposes an intervention derived of contemporary behavioral therapy and the thirdgeneration therapies.