Contextual Behavioral Science Research Articles

The Emergence of Acceptance and Commitment Sandtray Therapy: A Novel Framework

This paper introduces Acceptance and Commitment Sandtray Therapy (ACST) as a new branch of sand therapy theory. As a novel framework, it offers a fresh approach to conducting sandtray therapy and provides additional avenues for pursuing research. The creation and articulation of ACST is an evolution of my unique experience as an enthusiastic and dedicated student of both Acceptance and Commitment Therapy (ACT) and Sandtray Therapy (STT). Part of this article’s purpose is to introduce ACT’s foundational philosophy and theory. I achieve this by briefly describing radical behaviorism, functional contextualism, and relational frame theory. However, the primary focus of this paper is to highlight the six core psychological processes used in ACST and provide an example using a fictitious client’s tray with those processes in mind. Suggested protocols for implementing this framework, along with therapeutic interventional prompts appropriate for its application, are also offered. This work is significant in that it bridges two worlds: the contextual behavioral science realm of ACT and the interpersonal neurobiology domain of STT. With the emergence of this new model, new possibilities are on the horizon for both professional communities.

Native Hawaiians' Views on Depression and Preferred Behavioral Health Treatments: a Preliminary Qualitative Investigation.

Behavioral health issues, especially depression, are a major health disparity concern for Native Hawaiians in Hawai'i. Following the cultural safety framework and contextual behavioral science approach to intervention development, the present preliminary qualitative investigation aimed to gather better insight into Native Hawaiians' views of depression and its causes as well as their preferred forms of behavioral health services. Data were initially collected from a 2-hour virtual focus group with three behavioral health service providers working with Native Hawaiians, followed by a total of 38 online one-on-one in-depth interviews with Native Hawaiian clients with depression (n = 19), behavioral health service providers working with Native Hawaiian adults (n = 9), and Native Hawaiian cultural leaders (n = 10). Our qualitative data suggested that Native Hawaiians tend to view depression contextually and socioculturally as the manifestation of one's vital connection to the 'āina (land), 'ohana (family; continuity from ancestry and future generations), community, culture/spirituality, and one's authentic self being disrupted. Our findings also suggested that Native Hawaiians often attribute these disruptions to disparities due to the ongoing impact of colonization, historical trauma, and cultural loss. As a preferred form of treatment for depression, participants recommended various Hawaiian cultural practices to be integrated into existing behavioral health services to nurture the above-mentioned vital connection.

The illusion of inclusion: contextual behavioral science and the Black community.

Anti-racism approaches require an honest examination of cause, impact, and committed action to change, despite discomfort and without experiential avoidance. While contextual behavioral science (CBS) and third wave cognitive-behavioral modalities demonstrate efficacy among samples composed of primarily White individuals, data regarding their efficacy with people of color, and Black Americans in particular, is lacking. It is important to consider the possible effects of racial stress and trauma on Black clients, and to tailor approaches and techniques grounded in CBS accordingly. We describe how CBS has not done enough to address the needs of Black American communities, using Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) as examples. We also provide examples at the level of research representation, organizational practices, and personal experiences to illuminate covert racist policy tools that maintain inequities. Towards eradicating existing racism in the field, we conclude with suggestions for researchers and leadership in professional psychological organizations.

The theoretical basis of a functional-descriptive approach to qualitative research in CBS: With a focus on narrative analysis and practice

This conceptual-methodological article examines how qualitative research, particularly the recent developments in narrative analysis, can be used in a manner consistent with Contextual Behavioral Science. Qualitative research is ordinarily a form of “descriptive contextualism” that can be used for understanding the narratives of the client, the therapy process, and its results. Narrative analysis contributes to the idiographic understanding of a particular experience by carefully examining narrative elements like plot, motives, and characters. The use of such analysis is now supported by attempts to use behaviorism and Relational Frame Theory to understand narratives. However, in response to the criticism that qualitative research is merely descriptive rather than functional, new developments in narrative analysis that go beyond description of stories toward the scope, effects, and boundaries of stories are examined. This makes possible a narrative analysis that is functional-descriptive, where understanding and prediction-and-influence are combined.

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

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.

Conceptual, Psychometric, Methodological and Value Problems in Acceptance and Commitment Therapy: Introduction to the Special Section, “A Critical Appraisal of Acceptance and Commitment Therapy”

There is a voluminous and expanding literature regarding ACT, from descriptions of its theory to its stated roots in relational frame theory, the particulars of its therapy techniques and exercises, favored metaphors, randomized controlled trials, to many self-help books for a wide variety of problems. The therapy is widely marketed through workshops and many self-help books. ACT is associated with its own journal and its own professional organization, the Association for Contextual Behavioral Science (ACBS). This literature is interpreted by ACT proponents as demonstrating the causal efficacy of ACT for a wide range of problems and, at times, even being superior to treatment as usual, which are often more traditional forms of cognitive behavior therapy (CBT). This special section contains a series of 6 papers examining these claims. Correctly understanding and evaluating the claims of ACT proponents is warranted because these can have direct implications for treatment decisions by therapists attempting to deliver the most effective treatment for their clients' problems. The papers, individually and as a whole, urge considerable caution, particularly because much of its research has involved serious measurement problems, problematic research designs, and a unique and problematic conceptualization and perhaps the practice of values and ethics. These papers call for methodological improvements and a commitment to more traditional values associated with science so that ACT can be more fairly evaluated to accurately understand its assets and limitations.

Functional contextual implementation of an evolutionary, entropy-based, and embodied free energy framework: Utilizing Lagrangian mechanics and evolutionary game theory's truth vs. fitness test of the veridicality of phenomenological experience.

The Bayesian approach of cognitive science largely takes the position that evolution drives perception to produce precepts that are veridical. However, some efforts utilizing evolutionary game theory simulations have shown that perception is more likely based on a fitness function, which promotes survival rather than promoting perceptual truth about the environment. Although these findings do not correspond well with the standard Bayesian approach to cognition, they may correspond with a behavioral functional contextual approach that is ontologically neutral (a-ontological). This approach, formalized through a post-Skinnerian account of behaviorism called relational frame theory (RFT), can, in fact, be shown to correspond well with an evolutionary fitness function, whereby contextual functions form that corresponds to a fitness function interface of the world. This fitness interface approach therefore may help provide a mathematical description for a functional contextual interface of phenomenological experience. Furthermore, this more broadly fits with a neurological active inference approach based on the free-energy principle (FEP) and more broadly with Lagrangian mechanics. These assumptions of how fitness beats truth (FBT) and FEP correspond to RFT are then discussed within a broader multidimensional and evolutionary framework called the extended evolutionary meta-model (EEMM) that has emerged out of the functional contextual behavioral science literature to incorporate principles of cognition, neurobiology, behaviorism, and evolution and are discussed in the context of a novel RFT framework called "Neurobiological and Natural Selection Relational Frame Theory" (N-frame). This framework mathematically connects RFT to FBT, FEP, and EEMM within a single framework that expands into dynamic graph networking. This is then discussed for its implications of empirical work at the non-ergodic process-based idiographic level as applied to individual and societal level dynamic modeling and clinical work. This discussion is framed within the context of individuals that are described as evolutionary adaptive and conscious (observer-self) agents that minimize entropy and can promote a prosocial society through group-level values and psychological flexibility.

Transparency and reproducibility in the journal of contextual behavioral science: An audit study

Increasing openness, transparency, and reproducibility in contextual behavioral science (CBS) through incorporating CBS-consistent open science practices was identified as a key aim of the ACBS Research Task Force. However, little data exist on the prevalence of open science practices currently being used in CBS research. This study aimed to address this gap by auditing the prevalence of open science and reproducibility practices in studies published in the Journal of Contextual Behavioral Science across 1 year, prior to the journal's adoption of open science recommendations (July 2020–July 2021). Aims of the study were twofold: first, to characterize current use of open science and reproducibility practices in JCBS to serve as a point for future comparison; second, to compare the rate of open science and reproducibility practices in JCBS, the flagship journal for contextual behavioral science, against two recently published audits of top clinical psychology journals. Domains audited were use of pre-registration, practices to ensure adequate power, data availability statements, use of standard reporting guidelines, preprints, conflict of interest statements, and resource and code sharing. Results indicated that studies published in JCBS had low rates of pre-registration, data availability statements, preprint posting, and resource and code sharing. Use of mandated standardized reporting guidelines and conflict of interest disclosures, both required by JCBS at the time of the audit, reflected relative strengths. Power for correlational studies was superior to power for experimental studies; the latter reflected a relative weakness compared to other clinical psychology journals. Rates of practices required by JCBS were significantly higher than those not required. JCBS may consider strongly encouraging or mandating other open science practices to incentivize researchers to use them.

Introduction to the special issue on the ACBS taskforce report

In 2021, the Journal of Contextual Behavioral Science (JCBS) published a white paper titled “Report of the ACBS Task Force on the strategies and tactics of contextual behavioral science research.” The focus of this report was to guide research done by members of the Association of Contextual Behavioral Science. This report offered 33 specific recommendations under five themes. This paper is the introduction to a special issue of JCBS that includes eight commentaries written by leaders in their respective fields on the taskforce report. These commentaries offer praise and suggestions based on the ACBS report.

Examining the structure of distress tolerance: Are behavioral and self-report indicators assessing the same construct?

Distress tolerance, or the ability to tolerate physically and emotionally aversive experiences, is a target of psychological intervention in contextual behavioral science. It has been conceptualized as a self-reported ability, as well as a behavioral tendency, and operationalized with a wide variety of questionnaires and behavioral tasks. The current study aimed to investigate whether behavioral tasks and self-report assessments of distress tolerance measure the same underlying dimension, two correlated dimensions, or whether method factors accounted for covariation above and beyond a general content dimension. A university student sample (N = 288) completed behavioral tasks associated with distress tolerance and self-report distress tolerance measures. Confirmatory factor analysis indicated that behavioral and self-report assessments of distress tolerance do not comprise a single dimension of distress tolerance, or two correlated dimensions of self-report or behavioral distress tolerance. Results also failed to support a bifactor conceptualization with a general distress tolerance dimension and domain-specific method dimensions for behavioral and self-report assessments. Findings suggest that more precision and attention to contextual factors are required in the operationalization and conceptualization of distress tolerance.

Community Initiated Care: A blue-print for the practical realization of contextual behavioral science

There is a vast unmet need for mental health care and support in the United States and globally. Although expanding specialty services is needed, this is neither sufficient nor necessary to comprehensively address the current and future demand. Traditional models of care which have focused on mental disorders, while useful for many, remain out of reach, unaffordable, and not timely for helping the vast majority of individuals in need of mental health support. There is a growing movement of community-based networks and organizations which aim to fill this need by harnessing existing community resources to promote mental health and prevent mental and substance use disorders. This paper describes our effort to derive a blue-print for an approach, which we call “Community Initiated Care (CIC)”, building on these real-world experiences and the growing science on lay person delivered brief psychosocial interventions in community settings. CIC serves as a back-bone for training lay persons to support the mental health and well-being of others in their communities. CIC is envisioned as an equitable, efficient, safe, and timely form of contextualized support to promote mental health and prevent self-harm, mental health and substance use problems. CIC is not intended to replace clinical interventions; instead, we envisage the supportive encounter to use a person-centered approach to bolster existing positive coping skills, promote positive social engagement, reduce risk of future mental health problems, and encourage other forms of help seeking when appropriate. This article explores how our thinking is aligned with and responsive to the strategies and tactics of the Contextual Behavioral Science Task Force to promote programs that are multi-dimensional, process-based, prosocial, practical, and multi-level. Development, implementation, and evaluation of CIC will not only advance contextual behavioral science but also move society forward to more equitable mental health and well-being.

How to Effectively Promote Eco-Friendly Behaviors: Insights from Contextual Behavioral Science

The rapidly increasing rate of climate change is a major threat of our time. Human behaviors contribute to climate change. These behaviors are malleable. To change human behavior in significant and sustainable ways, we need a scientific understanding of motivation and behavior change. One area in psychological science that provides precision, scope, and depth to our understanding of human behavior and motivation is contextual behavioral science (CBS). The current article provides an account of how CBS can provide real-world solutions to promoting positive behavior change to reduce human-induced climate issues. Specifically, we will outline six evidence-based considerations for organizations aiming to promote pro-environmental behaviors through messaging, advertising, and social marketing. Practical examples are provided across all six considerations to promote behavior change to reduce the rapidly increasing rate of climate change.

The impact of psychological flexibility on family dynamics amidst the COVID-19 pandemic: A longitudinal perspective

BackgroundHealth risks associated with contracting COVID-19, stay-at-home orders, and pandemic-related economic and social hardships created unique challenges for individuals throughout the pandemic, and in particular for families whose daily routines were disrupted at the start of the pandemic. This study applied a contextual behavioral science lens to Family Systems Theory to examine the impact of COVID-19 stressors on family and individual functioning. MethodsA sample of 742 coparents (86% married/engaged; 84% Caucasian; 71% female; M = 40.7 years old, SD = 8.1; Mincome = $82,435, SDincome = $27,604) of school-aged children (5–18 years old) completed a baseline survey from late March to late April 2020. Of the initial sample, 556 coparents completed weekly diaries for 8 weeks. ResultsMediation models were tested within a multilevel path modeling framework to evaluate both the stable, between-family differences (i.e., at level 2) and the within-family changes from week to week (i.e., at level 1). Across both levels of the model, parent psychological inflexibility was robustly linked to poorer functioning across all levels of the family system, showing direct links to a majority of the processes assessed. The results further supported a top-down spillover cascade in which parent inflexibility was proximally linked to greater COVID-19 related stress and parent depressive symptoms, which were proximally linked to poorer romantic functioning (greater negative conflict, lower satisfaction), which were proximally linked to poorer family functioning (greater coparent discord and family chaos), which were proximally linked to poorer parenting (greater angry/reactive parenting), which was proximally linked to greater child distress. Multi-group models suggested that the results were largely stable across (1) parent race (white vs non-white), (2) family size (1 child vs 2 or more), (3) child age (less than 10 years old vs 10 or older), (4) parent age (under 40 vs. 40 or older), (5) perceived COVID-19 risk, (6) parent gender (mothers vs fathers), (7) household income groups (less than $100k vs $100k or more), and (8) perceived economic stress/uncertainty (low vs high). However, a handful of moderated effects emerged from those multi-group models suggesting that fathers might be slightly more prone to negative spillover effects across the family systems and that wealthier families might have experienced the stress of new demands (e.g., homeschooling, remote working) as more disruptive. ConclusionsResults highlight the crucial role parental psychological flexibility and inflexibility play in families managing the stress of COVID-19, as well as key mechanisms for how those stressors may either reverberate or become dampened throughout the family system.

Diversity-related factors in research mentorship and publishing in the ACBS community and the Journal of Contextual Behavioral Science

Gender, racial, and ethnic disparities persist in the scientific community despite increasing attention to research-related equity. Men publish in biomedical, scientific journals more frequently than women researchers and have more leadership roles (e.g., first authorship) in these submissions. Similar differences in scientific publishing appear among under-represented minority (URM) authors compared to White counterparts. These findings of authorship disparities are not consistent across all journals and may relate to mentorship variables. This survey study aimed to investigate gender and racial patterns of publishing and research mentorship within the Association for Contextual Behavioral Science (ACBS) community, including in the Journal of Contextual Behavioral Science (JCBS). Two hundred and eighty-two ACT for Professionals listserv members responded to the anonymous 31-item survey. Men reported significantly more publications and more first author manuscripts than women, both in scientific journals generally and in JCBS specifically. White versus URM respondents more frequently reported publishing in JCBS, but not in other scientific journals. There were no differences in the total number of barriers noted between men and women or between White respondents and URM respondents. The top barriers to publishing among all respondents were lack of time, institutional support, and funding. Women more frequently reported lack of adequate research mentorship or collaboration as a barrier to publishing in scientific journals, as well as in JCBS specifically; men more frequently reported experiencing publishing barriers related to embargos and not having research that was appropriate for JCBS. Identifying as the same gender as one's primary research mentor did not relate to any areas of training. However, participants whose race differed from their mentor were significantly more likely to report training in running a study and receiving positive encouragement. Being matched in terms of gender or race with one's mentor did not relate to publishing variables. Findings highlight the continued gender and racial disparities in publishing within the ACBS community and in JCBS. Recommendations for decreasing these differences through research mentorship and structured training efforts are provided.

Daily changes in state emotion regulation abilities predict positive and negative affect

Emotion regulation (ER) abilities involve the capacity to manage the onset and course of emotions in service of situational goals, which facilitates affective changes dependent upon the contextual parameters. Despite the importance of ER abilities to psychopathology, understanding ER abilities across days, and how daily fluctuations in ER abilities relate to mood, is limited. This study examined the role of state ER in predicting positive and negative affect using a daily diary design (2812 daily surveys). Participants differed in within-individual variability for each domain of perceived state ER, and within- and between-individual fluctuations in perceived ER abilities predicted positive and negative affect. Findings support ER theory, given the importance of contextual, momentary changes in informing theoretical ER models. Implications for momentary assessment and intervention are discussed, focusing on contextual behavioral science.

Strengths, challenges, and opportunities associated with process-based and multi-dimensional CBS research: A commentary on

Contextual behavioural science (CBS) methods are frequently applied in research to gain insight on the intricacies of human behaviour and have become integrated in psychological treatments, including acceptance and commitment therapy and applied behavioural analysis. The Association of Contextual Behavioural Science (ACBS) Task Force recently provided 33 recommendations to improve the quality and applicability of CBS research. The use of process-based approaches to CBS was encouraged as they place an emphasis on facilitating behaviour change to alter psychological events or behaviour. Recommendations were also made to incorporate multi-dimensional approaches in CBS research in order to consider human behaviour holistically and acknowledge that change may be motivated by evolutionary needs. The purpose of this commentary was to identify strengths, challenges, and potential opportunities associated with the process-based and multi-dimensional recommendations for CBS research. Despite some concerns about feasibility or clinical utility of process-based and multi-dimensional CBS research, there is potential for the recommendations to be achieved and to foster greater understanding of human behaviour as supported by other multidisciplinary areas of research in psychology. Process-based and multidimensional CBS is well positioned to support collaborative research opportunities that may close the gap between basic and applied knowledge and understanding of human behaviour and related applications to practice.

Commentary: Person-specific, multivariate, and dynamic analytic approaches to actualize ACBS task force recommendations for contextual behavioral science

• The ACBS Task Force recommends promising avenues for research. • Person-level, multivariate, and longitudinal analyses are needed. • Decades of methodological work can be leveraged to actualize recommendations. • Specific analytic methods and considerations for implementation are discussed. • Next steps for person-level and complex systems analysis are highlighted.

Enhancing students' well-being with a unified approach based on contextual behavioural science: A randomised experimental school-based intervention.

A new generation of interventions has begun to move towards principles of acceptance that deal with the context and function of psychological events. The aim of this paper is to analyse the effectiveness of a brief contextual behavioural intervention to improve the psychological well-being of secondary school students. This intervention represents a unified model with key processes based on contextual behavioural science, including Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP). We conducted an intervention with 94 students (age range 17-19 years), randomly assigned to an experimental group (n = 50) or control group (n = 44). Participants took a pretest and post-test of distress, life satisfaction, psychological flexibility and mindfulness. The intervention consisted of three sessions of 1 h each. The results showed significant differences between the groups in distress and significant differences for the interaction (group × pre-post) in all the other variables. The intervention had greater benefits for girls than for boys. These results may provide a breakthrough, thus leading to a process of evidence-based therapies, which would be responsible for inducing psychological improvements in brief periods, in a population with an increasing risk of distress.

The importance of idiographic and functionally analytic strategies in the unified protocol for transdiagnostic treatment of emotional disorders

Methodology in the behavioral sciences is heterogeneous, and this is particularly true in the application of methodologies in the study of the nature and treatment of psychopathology and related areas of applied behavior change. For this reason, the very thoughtful and thorough report on strategies and tactics of contextual behavioral science (CBS) research to which this commentary is directed (The Report) is very welcome (Hayes et al., 2021). For our part we will focus comments on several key features and recommendations from The Report, with emphasis on intensive dynamic longitudinal and functionally analytic research strategies for studying behavior change with an idiographic focus. We will also underscore our strong agreement with the need for a multilevel focus and will illustrate many of these issues in the context of our ongoing research on developing a deeper understanding of, and new interventions for, the emotional disorders. To this end we will review some of our recent research on the unified protocol for transdiagnostic treatment of emotional disorders (UP), a cognitive behavioral intervention with increasing evidence for efficacy across a wide range of disorders characterized by emotion dysregulation, among other things.

Ensuring interdisciplinary partnerships and commitment to Contextual Behavioral Science (CBS) principles among diverse scholars who serve diverse communities

Hayes et al. (2021) provide a variety of valuable recommendations for contextual behavioral scientists to increase the impact of their research. The merits and weaknesses of these recommendations are discussed from pragmatic and theoretical perspectives. Our commentary on the positive and negative facets of the Task Force findings are informed by our extensive experience working with underrepresented communities and as scholars of color ourselves. While we agree that improving psychological science will require an interdisciplinary approach, we highlight how this white paper is not entirely accessible to diverse samples and scientists alike, and thus, may limit interdisciplinary partnerships. Moreover, further bolstering is needed related to equity, diversity, and inclusion to ensure that future CBS research can fulfill its highly prosocial and innovative mission. Lessons learned from our own work and other diversity science scholars in the field are provided in order to highlight potential future directions for CBS scholars to consider to strengthen the applicability of the Task Force recommendations across diverse samples.