Based on their clinical experience in which dramatic client improvements were correlated with particularly intense therapeutic relationships, Kohlenberg and Tsai (1991) provided a behavioral interpretation of how the client-therapist relationship may produce change and attempted to explicate the strategies by which therapists may employ such relationships. The product was a comprehensive form of interpersonally-oriented psychotherapy named Functional Analytic Psychotherapy (FAP; Kohlenberg, & Tsai, 1991). FAP's theoretical grounding in scientifically established behavioral principles, proposed mechanism of action, and key therapeutic strategies have been well-articulated in book-length descriptions (Hayes, Masuda, Bissett, Luoma, & Guerrero, 2004; Kanter, Tsai, & Kohlenberg, 2010; Kohlenberg & Tsai, 1991; Tsai et al., 2008). Despite this strong foundation, FAP has yet to generate a compelling body of empirical literature supporting its clinical efficacy. To be sure, a number of case studies, single-case replication series, and group design studies adding FAP to other approaches are promising, but the data remain at a preliminary stage (Baruch et al., 2008; Garcia, 2008; Weeks, Kanter, Bonow, Landes, & Busch, 2011). The purpose of the present paper is to help promote FAP research, particularly efficacy research, an area that has been said to particularly stand out in terms of the need for further development (Garcia, 2008). FAP IN NUTSHELL FAP is summarized nicely by its name. The approach is functional in that there is an emphasis on how client behavior operates on the world (including the world within the therapy milieu), not what the behavior looks like (i.e., its topography). It is analytic in that therapy involves identifying how important classes of client behavior operate on the world, including the part of the world within the therapy session. This is done typically by appeal to principles of operant conditioning. FAP is psychotherapy in that the therapist is charged with responding differentially to particular classes of client behavior as they occur in the therapy session so as to increase or decrease them (in session and in the world outside the session) and thereby improve the client's psychosocial functioning. The primary agent of change in FAP is the responding of the therapist to in-session occurrences of clinically relevant behaviors (CRBs) emitted by the client. FAP identifies three types of CRB: CRB1s, which are collaboratively identified problem behaviors that occur in session, CRB2s, which are improvements in behavior that occur in sessions, and CRB3s, which are attempts by the client to describe causes of his or her behavior. The therapist's job is to respond to instances of CRB in a manner that reduces CRB1s and prompts, shapes, and increases CRB2s. Thus, the mechanism of action in FAP is therapist provided consequences contingent on CRB. The therapist is guided in the task of responding to CRB, and thereby implementing the mechanism of action, by 5 rules, which are more flexible guidelines than rigid prescriptions. The rules are: 1) Watch for CRB, 2) Evoke CRB, 3) Reinforce CRB, 4) Observe the Potentially Reinforcing Effects of Therapist Behavior in Relation to Client CRB, and 5) Provide Functional Analytically Informed Interpretations and Implement Generalization Strategies (Kohlenberg & Tsai, 1991; Tsai et al., 2008). FAP represents a relatively straightforward application of behavior analysis to the interactions occurring in psychotherapy. Why then has there been difficulty generating research support for FAP, especially when other behavior therapies have made more substantial progress (e.g., Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Behavioral Activation, see Hayes et al., 2004)? One aspect of FAP that appears relevant is that it is a general approach to psychotherapy and how the therapeutic relationship can produce change. …
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