Acceptance and Commitment Training in Applied Behavior Analysis: Where Have You Been All My Life?

Acceptance and commitment training for reducing burnout in medical students during a clinical clerkship in psychiatry and palliative care: A pilot study

Perceived stress and professional quality of life in nursing staff: How important is psychological flexibility?

Background30–40% of people require professional support to manage grief. During the pandemic, UK deaths increased by over 17% compared to the previous 5 years. Levels of unmet need persist and...

The recent resurgence of Kantorian interbehavioral psychology in the context of relational frame theory (RFT) has prompted a reevaluation of RFT's core concepts through an interbehavioral lens. Although RFT acknowledges its Kantorian roots, recent works have called for a more serious consideration of interbehaviorism in the context of developing the theory towards a more complete analysis of the complexity of human language and cognition. In particular, the current article aims to explore the alignment between the RFT concept of the relational frame and the interbehavioral interpretation of psychological happenings. To this end, the relational frame is dissected to clarify (mentalistic) misconceptions of RFT, and is then compared with interbehavioral constructs such as stimulus and response functions, substitute stimulation, and interbehavioral history. The integration of these perspectives suggests that RFT may benefit from a field-based approach to experimental and applied research. We argue that by applying the interbehavioral concept of stimulus substitution for stimuli that differ arbitrarily in multiple ways (i.e., multiple stimulus relations), the door may be opened for the entire RFT research program to yield (at least potentially) to interbehavioral field-based analyses.

Behavior analysis is the underclass of psychology. It is under-funded, under-taught, and underappreciated. A lot is happening that is positive, but just beneath the surface, there are grave dangers lurking that could significantly worsen our already poor status. I prefer to believe that most of these dangers are things we can control by our own behavior (itself a rather behavioral idea), and I offer this list of dangers in that spirit. As someone once said: if you always do what you always did, you'll always get what you always got. Behavior analysts need to appreciate the following six dangers and adapt to them. LOSS OF MISSION Behavior analysis was initially strategically committed to the field of animal learning, but from the beginning its ultimate purpose was an understanding of complex human behavior: importance of a science of behavior derives largely from the possibility of an eventual extension to human affairs (Skinner, Behavior of Organisms, 1938, p. 441). In the early decades that was merely a promise, but the arrival of applied behavior analysis turned it into a program. Over the years, however, both basic and applied behavior analysis have narrowed and that original vision is being lost. Applied behavior analysis is gradually becoming a subfield of developmental disabilities, as a glance at a recent issue of JABA will confirm. The depth of the risk this creates is covered over by methodological rigor and applied impact within that narrow domain. Basic behavior analysis clings largely to narrow and precise questions of self-stimulatory interest in the animal laboratory, even while animal laboratories are being closed one by one, and areas of research within behavior analysis are being opened up that require human research. The depth of the problem is covered over by the productivity of a few major behavioral laboratories and the emergence of a handful of international labs, where protection from political winds have allowed the old seeds to grow a few new sprouts. In some ways, all of the other dangers I list can be traced back to the following core concern. Behavior analysis was always a carom shot. Instead of approaching human complexity directly, it tried to develop conceptual tools based on simple behaviors in simple contexts with small non-human animals, and then to apply these to an analysis of virtually every form of complex human behavior. It was a bold and even slightly preposterous idea, and yet it was one that worked far beyond what anyone had a right to expect. Now, however, we seem to be on the verge of forgetting what the mission was in the first place. Many basic behavior analysts have begun to believe that basic behavior analysis is a subfield of animal learning or (perhaps worse) behavioral biology. Where are the experimental analyses of emotion, friendship, sexuality, health, reasoning, humor, intelligence, and so on? Interpretation is not enough--we need an experimental analysis of such behaviors. Without the basic account, applied behavior analysts either ignore these areas or build common sense approaches to them. TOOL POLISHING No field so enjoys principles as does behavior analysis. Principles of behavior are ways of speaking about the prediction and influence of the historically and currently situated actions of organisms that are precise, broadly applicable, and coherent in terms of the larger fabric of science. Principles are the intellectual tools of analysis. They are not, however, ends in themselves. Sometimes behavior analysts are like the watchmakers who decided to make a set of extremely fine tools before actually making some complicated new watches. Forgetting what the tools were for, the talented watchmakers did not build the watches and display them in a glass cabinet, but instead put the tools themselves in that cabinet, taking them out only to polish them and to show how they work. Basic behavior analysts are especially prone to this error. …

In this commentary, I describe relational frame theory (RFT) as an analysis of complex human behavior that has been insufficiently addressed within contemporary behavior analysis. The theory is described as having an exceptionally ambitious vision of the type that will render behavior analytic accounts more generally acceptable within the broader behavioral and cognitive sciences. In my own view, inductive empirically-driven analyses derived from current data on relational learning (including my own) have not been comparably ambitious; they have not addressed the full range of phenomena to which they might be profitably applied. By contrast, researchers in the RFT tradition have ambitious; they have not addressed the full range of phenomena to which they might be profitably applied. By contrast, researchers in the RFT tradition have tended to project their analyses to encompass a variety of plausible, attractive applications that are arguably within the reach of their current data or data that may be reasonably anticipated in the future. In order for RFT researchers to have its maximum impact, however, I suggest that certain critical steps must be accomplished. First, the theory must be reconciled with the basic behavioral processes that are the core of the experimental analysis of behavior. Second, certain experiments must be conducted that have thus far not been emphasized in the RFT tradition. In particular, I suggest that the current practice of studying college students and verbal school-aged children must be supplemented with comparably intensive studies of populations with developmental limitations (e.g., typically developing children who are just acquiring language). Absent such experimentation, it seems likely that RFT will remain a plausible account that merely competes with other plausible accounts without promoting ultimate resolution of the critical issues.

Acceptance and commitment therapy (ACT) is a contemporary approach to dealing with unhelpful private events and improving psychological flexibility (Hayes et al., 2006) that is often used in psychotherapy (Szabo, 2019). Nonpsychotherapeutic uses of ACT have been referred to as acceptance and commitment training (ACTraining; Moran, 2011, 2015; Szabo, 2019), which refers to the use of one or more of six processes-present moment attention or mindfulness, values clarification, committed action, self-as-context, defusion, and acceptance (Hayes et al., 2006)-implemented outside of psychotherapeutic settings. There has been a recent increase in interest in ACTraining within the behavior-analytic community, which has led behavior analysts to question whether ACTraining is useful to the field of applied behavior analysis (ABA) and whether it is within the scope of practice of behavior analysts. Tarbox et al. (2020) proposed that the use of ACTraining is within the scope of practice of behavior analysts and aligns with the seven dimensions of ABA as outlined by Baer et al. (1968). The purpose of the current study was to provide a systematic review of single-case research designs that measure the behavioral effects of ACTraining components conducted with individuals with autism spectrum disorder or developmental disorders, their parents, and their staff, and to inform clinicians and researchers about what variables have been evaluated and what gaps still exist.

Editorial: Where should we go from here?

Responding to derived relations among stimuli and events is the subject of an accelerating research program that represents one of the major behavior analytic approaches to complex behavior. Relational Frame Theory: A Post-Skinnerian Account of Human Language and Cognition (Hayes, Barnes-Holmes,& Roche, 2001) offers a conceptual framework for this work and explores its implications for verbal behavior and a variety of other domains of complex human behavior. The authors dismiss Skinner’s interpretation of verbal behavior as unproductive and conceptually flawed and suggest a new definition and a new paradigm for the investigation of verbal phenomena. I found the empirical phenomena important but the conceptual discussion incomplete. A new principle of behavior is promised,but critical features of this principle are not offered. In the absence of an explicit principle,the theory itself is difficult to evaluate. Counter examples suggest a role for mediating behavior,perhaps covert, thus raising the question whether a new principle is needed at all. The performance of subjects in relational frame experiments may be a mosaic of elementary behavioral units, some of which are verbal. If so, verbal behavior underlies relational behavior; it is not defined by it. I defend Skinner’s definition of verbal behavior and argue that an account of relational behavior must be integrated with Skinner’s analysis; it will not replace it.

At its core, productive collaboration between speech-language pathologists and behavior analysts requires effective communication between both parties. Successful communication can be gained in par...

Both relational frame theory (RFT) and acceptance and commitment therapy (ACT) are based on the assumption that the evolution of human language (conceptualized as derived relational responding) creates the potential for a form of psychological suffering unique to the human species. Furthermore, it has often been argued that RFT provides the basic science foundation for ACT. Rather than dwell on these features of RFT, this article focuses on providing an up-to-date summary of the theory itself. Specifically, an historical and contemporary overview of RFT is presented, along with the details of recent ongoing efforts to advance the theory as a general behavior-analytic account of human language and cognition. In doing so, we provide a modern vision of how RFT may continue to connect with ACT in the years to come.


 From a relational frame theory perspective, our sense of self is a by-product of language that arises from transformation of stimulus functions through relational framing of our own responding. In this way, selfing is an important action that allows us to clarify our needs, wants, and what matters to us. Tacting and deictic relational responding are two processes that are instrumental to the development of a healthy selfing repertoire. This paper provides an overview of tacting and deictic relational responding in accordance with relational frame theory in addition to features of an optimal environment for shaping these processes. In terms of tacting, it is important to consider learning environment sensitivity, consequence availability, the individual’s experience, and to facilitate rich discussions of private events. In terms of deictic relational responding, it is important to provide frequent interactions that contain multiple exemplars of distinctions between self and others in addition to rich discussions of private events while also tailoring to the individual when drawing from training protocols. We conclude with a brief overview of the current evidence base regarding the identified features.

A Behavioral Approach to the Human Understanding of Time: Relational Frame Theory and Temporal Relational Framing

The implicit relational assessment procedure (IRAP) was initially developed as a way to assess the strength and probability of natural verbal relations, as defined within relational frame theory (RFT), and was conceptually rooted within the behavior-analytic tradition. However, the IRAP quickly became employed primarily as a measure of implicit cognition, more in line with mainstream psychology than behavior analysis. In doing so, research using the IRAP increasingly employed ill-defined mainstream psychological terms, focused on correlational analyses with traditional psychometry, and thus emphasized prediction over the prediction-and-influence of behavior. Although perhaps beneficial to the study of implicit cognition, this approach could be argued to have limited the IRAP's utility in behavior analyses of human language and cognition. In the current article we will reflect on this suggestion, on the IRAPs place and current use in the field of behavior analysis, and on its potential future within behavioral psychology in light of recent conceptual and empirical advances in RFT. In doing so, it is hoped that the measure may be refined into a better understood, more precise, functional-analytic tool.

Applied behavior analysis is a widely used intervention for autistic youth, though its mental health impacts remain under-researched. This study aims to investigate the association between applied behavior analysis therapy and post-traumatic stress disorder, suicidality, mental health hospitalization rates, and length of mental health hospitalizations using a national database of privately insured youth under 18. We matched 17,120 autistic youth who received applied behavior analysis with a control group of autistic youth with no record of applied behavior analysis and clustered them into four applied behavior analysis dose groups using two-stage bisecting k-medians clustering. Then, we used negative binomial regression and logistic regression to compare outcomes for the applied behavior analysis and non-applied behavior analysis groups. Overall, applied behavior analysis receipt was associated with 30% higher odds of experiencing a mental health hospitalization (odds ratio = 1.30, p < 0.001) and a 32% higher incidence rate of these hospitalizations (incidence rate ratio = 1.32, p < 0.001). Our analysis found no relationship between applied behavior analysis dosing and the other tracked mental health outcomes. These results indicate the need for more quantitative analysis with more comprehensive records of applied behavior analysis receipt to fully investigate claims of ABA resulting in adverse adult mental health outcomes.Lay abstractAutistic youth often receive applied behavior analysis (ABA) therapy, but some autistic adults who had ABA as youth say it harmed their mental health as adults. We looked at the relationship between ABA and post-traumatic stress disorder (PTSD), suicidality, mental health hospitalization rates, and length of mental health hospitalizations among autistic youth. We used private health insurance claims data to look at how ABA receipt was related to those mental health outcomes. We divided autistic youth into groups based on how much ABA they received, so we could see if different amounts of ABA had different associations with mental health. There were 17,120 autistic youth in the group that did not receive ABA, and 17,120 autistic youth in the group that did receive ABA. In this sample, ABA therapy was associated with a greater use of acute mental health services; autistic youth in the ABA group had an overall risk that was 30% higher for mental health hospitalizations; and a 32% greater frequency of mental health hospitalizations. These results suggest that there may be a relationship between mental health hospitalizations and getting ABA. However, more work is needed to fully understand the impact of ABA therapy on mental health outcomes.