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

Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2023). The idionomic future of cognitive behavioral therapy: What stands out from criticisms of ACT development. Behavior Therapy, 54(6), 1036–1063. https://doi.org/10.1016/j.beth.2023.07.011

In plain language

A special section of the journal Behavior Therapy published a set of articles critical of Acceptance and Commitment Therapy (ACT) and its foundations — psychological flexibility, relational frame theory, functional contextualism, and contextual behavioral science (CBS). This paper is the authors’ reply. They acknowledge that the critiques contain worthwhile points, but argue they also rest on fundamental misunderstandings that need to be cleared up if a genuine scientific conversation is to take place.

The paper walks through the major areas of dispute. It reviews the historical role behavior analysis has played within the cognitive behavioral therapy (CBT) tradition and argues that CBS, as the modern face of behavior-analytic thinking, has a positive role to play in CBT’s future. It clarifies what functional contextualism actually claims and how it links to ethical behavior. It then examines the limits of building intervention science on diagnostic syndromes and fixed treatment protocols, the role of measurement and processes of change in moving toward more personalized interventions, how pragmatically useful concepts help basic science inform practice, and how both small-scale and large-scale studies can contribute to progress.

The authors conclude that further progress will require major modifications to traditional approaches across the board: psychometrics, the conduct of randomized trials, the analysis of findings with traditional normative statistics, and the use of data from diverse cultures and marginalized populations. Just as CBT has been reshaped by generational shifts before, they argue a similar shift — toward an idionomic, process-based approach that starts with the individual — is taking place once again.

Key findings

How to cite

APA

Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2023). The idionomic future of cognitive behavioral therapy: What stands out from criticisms of ACT development. Behavior Therapy, 54(6), 1036–1063. https://doi.org/10.1016/j.beth.2023.07.011

BibTeX

@article{hayes2023idionomic,
  title   = {The idionomic future of cognitive behavioral therapy: What stands out from criticisms of ACT development},
  author  = {Hayes, Steven C. and Hofmann, Stefan G. and Ciarrochi, Joseph},
  journal = {Behavior Therapy},
  year    = {2023},
  volume  = {54},
  number  = {6},
  pages   = {1036--1063},
  doi     = {10.1016/j.beth.2023.07.011}
}

Related work

Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.