A Within-Subjects Evaluation of the Effects of Functional Analytic Psychotherapy on In-Session and Out-of-Session Client Behavior

Previous research has shown the effect of the five rules of Functional Analytic Psychotherapy (FAP) on target behaviors, but has not isolated the effects of FAP’s hypothesized mechanism of contingent responding with reinforcement to in-session behavior (Rule 3) from evoking the behavior (Rule 2). The current study demonstrates the effects of FAP on in-session clinically relevant behaviors (CRBs) and out-of-session client behaviors, or daily life problems (DLPs) in an A/A + B design in which the A phase controlled for evoking CRB (Rule 2) and the A + B phase introduced contingent responding to CRB with reinforcement (Rule 3). Three clients presenting with emotional expression difficulties participated in this study. As per previous research, trained, reliable coders analyzed CRBs by rating session recordings with the FAP Rating Scale (FAPRS), and clients completed self-monitoring templates weekly to track out-of-session behaviors. Results showed FAP-phase-related improvements in CRBs and out-of-session behaviors in two of the three clients, with improvements maintained for one client for whom follow-up data were collected over a brief period. While earlier investigations have not explored the sustainability of behavioral improvements, the present study provides findings that are suggestive of this effect. Some recommendations to improve the reliability and generalization of these outcomes are discussed.