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The Three Earliest ACT Protocols

Sleuthing exactly when the first ACT protocols were written is tricky due to the passage of time, and the fact that computers did not exist so duplicate records meant carbon paper copies on onion skin kept in files and packed in cardboard boxes as moves occurred or new jobs were secured. Thus the reasoning for dating is included below.

The first ACT protocol was likely written by Steve Hayes in late Spring of 1981. At that time the name was "Comprehensive Distancing". An attachment to this page contains that very first protocol ("1981 Big D Manual S C Hayes") which is only 3 pages long. But its clear from the "manual" (an outline really) that the students knew the metaphors and exercises. Steve thinks his "night on the carpet" ( was during the 1980-81 winter break and that he came back to the lab ready to push hard on studying what he had experienced. He thinks he remembers conducting a workshop in the lab soon after and the "manual" was written after that in the 1981 Spring semester.

The next protocol was written soon after in 1981. Here is how we know that: the study was an analogue study on pain tolerance and it was presented at the Association for the Advancement of Behavior Therapy (now AABT) in 1982: 

Hayes, S. C., Korn, Z., Zettle, R. D., Rosenfarb, I., & Cooper, L. (November 1982). Rule‑governed behavior and cognitive behavior therapy: The effects of comprehensive cognitive distancing on pain tolerance. Paper presented at the meeting of the Association for Advancement of Behavior Therapy, Los Angeles. 

That means the study was finished by about March of 1982 so it could be submitted. 

But Rob Zettle (Steve Hayes's first doctoral student) thinks he likely used that pain manual to help write the manual for his dissertation on Cognitive Therapy vs ACT for depression. One reason to think that: the onion skin carbon copy of that pain protocol was only found in February 2024 (!) while looking for the first "Big D" manual, and Rob found it not in the files for the pain study, but in the cardboard box of files for his dissertation ... as if the protocol was relocated for his reference. 

Rob recalls running two subjects for his dissertation project in Greensboro before he left for his internship at the Center for Cognitive Therapy in Philadelphia in the summer of 1982. For that reason he thinks he was writing that protocol in the Fall 1981. His dissertation was conducted with the cooperation and support of Aaron Beck (note, ACT was never "at war" with Tim Beck!) and was defended in 1984 under the title "Cognitive Therapy of Depression: A Conceptual and Empirical Analysis of Component and Process Issues" (ProQuest Dissertations Publishing, 1984, 8509189). Incidentally in the context of the recent move toward ACT as a form of "Process-Based Therapy" it is worth noting the title of this first randomized controlled clinical trial on ACT! ACT was always a form of process-based therapy -- it's just now we have a name for that view.

The pain study was put in a file drawer, not because it was bad but because it was good, and Steve thought it would be more prudent to work out the issues of process measures, components, basic principles of rule-governance and relational framing, and philosophy of science issues before emphasizing outcomes alone.  

That took far longer than anyone thought at the time and thus the pain study was only published in 1999, 17 years after it was finished: Hayes, S. C., Bissett, R., Korn, Z., Zettle, R. D., Rosenfarb, I., Cooper, L., & Grundt, A. (1999). The impact of acceptance versus control rationales on pain tolerance. The Psychological Record, 49, 33-47.

An unfortunate historical note is that the pain manual was lost -- although Steve remembered seeing it more than once over the years, it was simply not in Steve's box of materials about the pain study when ACT began to be studied again for outcomes in the late 1990's. This meant that the two labs that were first interested -- Dermot Barnes-Holmes and Bryan Roche -- had to wander in the wilderness trying to replicate it. Both labs eventually did, but it took years to dial in the preparation, so progress was needlessly delayed and effort was wasted. That is one reason why finding the actual manual (25 years after its publication and 42 years after the study itself!) is of such historical importance.

Rob Zettle has written a history of this era and later eras of ACT development. The article describing these early days and more is attached below.


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