Abstract
Acceptance and Commitment Therapy (ACT) is one of the latest mindfulness-based behavior therapies shown to have compelling evidence and efficacy with a wide range of clinical conditions. ACT is so hard to categorize that it is often described as an amalgamation of existential, humanistic, cognitive-behavioural therapy. ACT is often referred as process-based CBT and is one of the ‘third-wave' of behavioural therapies. It is currently the fastest growing evidence-based therapy in the world, with currently at least 304 Randomized Control Trials (RCTs) being recorded all over the world. It has proven effective in different cultural contexts with a diverse set of clinical conditions, from depression, Obsessive-compulsive disorder, chronic pain, grief, loss and terminal illness, anxiety, and workplace stress.
TopPrimer On The Three Waves Of Behavioural Therapy
First Wave
The first wave came about during the 1960s with the popularity of B.F. Skinner’s operant conditioning, and other behaviorists like Ivan Pavlov’s classical conditioning. This era is marked with principles that were investigated through work with animals and then taken on to be tested successfully with human beings. Cutting-edge methodologies were developed to treat clients with phobia such as systematic desensitization and even till today it is safe to assume that these have a stronghold as being evidence-based approaches. This era of behavioral psychology paved the way for preciseness and deep accurate work.
The first wave died soon because there was less emphasis placed on human cognition, thoughts, and feelings (Harris, 2009). In fact, in 1957, Skinner wrote a book ‘Verbal Behavior’ in which he laid the foundation for development of language in human beings. Interestingly, Steven Hayes, the originator of ACT, further developed this concept, because although Hayes was captivated by this book and its ideas, he also found a lot of limitations.
Second Wave
The cornerstone of second wave was about including human cognition as a vital strategy for behavioral change (Harris, 2009). This 1970s era also saw the rise of famous cognitive therapists like Aaron Beck and Albert Ellis. Cognitive Behavior Therapy (CBT) had many evidence-based successful outcomes. However, focus on cognition seemed to have its own limitations.
A famous CBT study, where children stayed in the dark longer when they watched a video that trained to help them self-talk in a more positive light such as “I am a brave boy and I can stay in the dark!” was debunked when Steven Hayes and his team tested it out with an additional social context added in. Incidentally, when the children knew that the experimenter had access to watching them, they stayed longer, but when they were hoodwinked into thinking that the experimenter was not watching them, they did not stay longer. So, although CBT placed a lot of emphasis on the content of thoughts, this testing proved that the social context also was important (Hayes, 2019).
In the next discussion of third wave, there is a fundamental shift from content to context. It turns out now, in the 2020 era, CBT does not in fact work because of its cognitive disputation strategies, but because of its behavioral component (Hayes, 2019).
Key Terms in this Chapter
Hexaflex: A hexagon-shaped model that contains all the six key ACT processes.
Psychological Flexibility: The ability to act effectively and do what is important, even in the face of adversity. Psychological flexibility is facilitating using ACT processes and it is a vital component of therapy work.
Experiential Exercises: Activities that is based on someone’s experience. ACT is a therapeutic approach that involves using exercises, tools, and techniques to facilitate positive psychological change.
Metaphorical Equivalence: Using a metaphor or an analogical comparison to explain a concept.
Relational Frame Theory: This is a behavioral theory of human language of cognition. Relational frame theory claims that using language and verbal skills, human beings can relate two different discrete things. This process is termed as relational framing, and can consist of many different types of framing such as coordination, hierarchical, and deictic.
Context: Context refers to an environmental setting in which events occur. When we look at an assorted bowl of fruits, the fruits constitute the content , and the bowl constitutes the context . Context come in two types: external context which involves things we can touch, taste, smell, taste and hear; and internal context which involves thoughts and feelings.