Now let’s just take a moment before charging any further into the philosophy of science. If you promise not to let your eyes glaze over, we’ll promise to do what we can to make this useful. These truly are important points for the clinical work. ACT is not offering just techniques to string together in therapy, but rather a new stance and perspective to use while conceptualizing and treating behavioral concerns.
The unit of analysis. Functional contextualism focuses on the ongoing act-in-context as
the subject matter (as opposed to looking at the subject matter as if it were a machine with parts). The thing being analyzed is an interrelated unit. Functional contextual analyzing focuses on the ongoing behaving of a client and also the environment in which the behaving is occurring. When we talk about the four-term contingency of the motivational operation, the discriminative stimuli, the response, and the consequential stimuli, we are actually talking about a single unit. It is not four different pieces that we are analyzing but rather the unitary event.
Motivational operation
Discriminative stimuli
Response
Consequential stimuli
Truth criteria. In functional contextualism, statements are “true” when they lead to
“successful working.” The functional contextual scientists are less prone to see if their statements correspond to a model but rather more interested to see if their statements will lead to a desired end. This is why single-subject designs are more attractive to behavior analytic scientists: a baseline is measured, then a variable is altered to see what happens, and then the variable is reversed back to see if the measure of interest returns to baseline. The question “Do my interventions succeed in changing the measure in the desired manner?” is better answered by inductive (single-subject A-B-A designs) rather than deductive (hypothesis-testing) research.
Clinical behavior analysis and functional contextualism. Okay, the phrase “func-
tional contextualism” is just a pair of words ACT therapists use to describe their way
of thinking about behavior, and functional contextualism truly is a different way of thinking about the world (and about behavior) as compared to mechanism. It is cultur- ally deviant to look at human behavior this way because many popular views of behav- ior look at human beings mechanistically. Functional contextualists don’t. To reiterate, what we look at is the ongoing act-in-context. Ongoing relates that we investigate our subject matter of behavior over a period of time. (Frankly, it’s a bit redundant because behaviors must happen over time; behavior is understood as an event unfolding over some period of time rather than at a single point in time.) The act-in-context piece is a single phrase. The object of assessment is the pairing of the person’s action with a particular environment. We examine the behavior-environment relationship as a whole, not as separate from each other—as in a distinct behavior and detached environment. In functional contextualism, an analysis of behavior is meaningless without a context, just as an environment is meaningless without an organism.
In functional contextualism, psychological events are viewed as interactions between an organism and its environment, which is understood as historically and situationally defined contexts (Hayes, 2004). This means that the current environment and past consequences for behavior have an impact on the person. With an eye on past con- tingencies and current environmental influences, the functional contextualist aims for successful working as the truth criterion. The aim is to succeed in increasing our ability to describe, predict, and influence behavior. Clinical behavior analysis embraces the goals of description, prediction, and influence of behavior, and clinical behavior analysis is broadly “defined as the application of the assumptions, principles and methods of modern functional contextual behavior analysis to ‘traditional clinical issues’” (Dougher & Hayes, 2000, p. 11). Clinical behavior analysis aims to approach those goals with precision, scope, and depth.
Relational frame theory (RFT) is a functional contextual account of human lan- guage and cognition, and might be well applied to clinical concerns because basic RFT research suggests how language and cognition, while contributing to human evolution- ary survival and success, also lead to much human suffering. RFT will be described more thoroughly in chapter 4. Language and cognition become problematic when indi- viduals become fused with their thoughts in ways that increase experiential avoidance, lead them to follow futile change agendas, and sap vitality. ACT, a clinical application built on basic RFT research, assumes that clinical change occurs when the context of behavior changes toward successful working rather than when the form of behavior changes toward an established model. Thus, rather than emphasizing the form of behav- ior, the functions and contexts of psychological events are explored. This means that even a client’s presenting problem needs to be addressed with a change in the context of the behavior and not necessarily addressed in changing the form of the behavior. ACT therapists might not try to change the frequency, intensity, or duration of certain forms of problems but rather change the context of the so-called problems. For example, for the socially anxious person, anxiety is a context for avoiding social situations. Instead of assuming he must decrease his anxious thoughts and feelings before he can have a social life, he might instead begin to engage with others socially even while having anxious
Clinical Behavior Analysis and the Three Waves of Behavior Therapy 35
thoughts and feelings. When the aim of therapy is psychological flexibility, perhaps living a life worth living is the clinical target, and not the reduction of certain symptoms.