The Idionomic Future of Cognitive Behavioral Therapy: What Stands Out From Criticisms of ACT Development

•Vague truth criteria, post hoc rationalization, and moral relativism plague pragmatism.•If ultimate analytic goals are publicly and clearly stated these problems can be solved.•Functional contextualism, ACT, and RFT have shown how that can be done.•Some of the current criticisms recommend steps tha...

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Veröffentlicht in:Behavior therapy 2023-11, Vol.54 (6), p.1036-1063
Hauptverfasser: Hayes, Steven C., Hofmann, Stefan G., Ciarrochi, Joseph
Format: Artikel
Sprache:eng
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Zusammenfassung:•Vague truth criteria, post hoc rationalization, and moral relativism plague pragmatism.•If ultimate analytic goals are publicly and clearly stated these problems can be solved.•Functional contextualism, ACT, and RFT have shown how that can be done.•Some of the current criticisms recommend steps that have already failed us as a field.•More dramatic steps will be needed to create a better future for CBT. 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.
ISSN:0005-7894
1878-1888
1878-1888
DOI:10.1016/j.beth.2023.07.011