Overview
Functional analytic psychotherapy (FAP)(Kohlenberg &; Tsai, 1987;1991) is a modern,
contextual behavioral psychotherapy that applies behavioral analytic principles to shape client
behavior in the context of a nurturing therapeutic relationship. The proposed mechanism of
change in FAP is the therapist providing appropriate contingent responses to the client’s
clinically relevant behaviors (CRBs) that occur in session. Evidence of FAP’s effectiveness
continues to grow (Kanter et al., 2017) and practitioner interest in learning and using FAP
appears to be growing as well. Assessment of therapist competency in FAP has been an
increased focus as the research on FAP has matured. This section will review existing measures
of FAP competency. For the sake of comprehensiveness, measures of FAP adherence as well as
microprocess-level measures of therapists’ abilities to respond to client behavior with FAP-
consistent responses will also be reviewed. Competency, the ability to appropriately select and
enact FAP-consistent therapist behaviors that are tailored to specific client presentations across
time and across clients, is a more stringently defined class of behavior compared to the classes of
behavior that constitute FAP adherence or FAP-consistent behavior at the microprocess level.
Adherence and microprocess measures might be considered necessary, but not sufficient aspects
of competency. However, since measurement of competency can be resource intense (in terms of
time and complexity of the measurement procedure as well as the time and complexity in the
training of assessors), simpler, pragmatic measures of competency may be useful, particularly
when it is known how they relate to gold standard measures of competency.
Materials/Assessments/Work Products
FAP competencies organized by ACLB (awareness, courage, love, and behaviorism) model
and FAP based on process (Tsai, personal communication).
Description: Created by the developers of FAP, the FAP competencies organized by ACLB
measures five general competencies are defined, with 2-10 subcompetencies defined under each
general competency. Four of the general competencies correspond to the awareness, courage,
love, and behaviorism framework described in Tsai et al. (2009). The fifth general competency is
the ability to integrate the FAP skills in the “logical” FAP interaction (Weeks et al., 2012).
Competencies are collaboratively scored on a five point scale (1=poor; 5=excellent) with
competency being defined as scores of three (good) or above.
FAP Competency Scale (FAPCS) (Kanter, personal communication; Maitland et al., 2016a)
Description: The FAPCS, like the ACLB, is a way to operationalize a measure of competency
that was informed by the comprehensive training vision of the FAP co-developers. The FAPCS
is a 12-item scale developed by a FAP expert (in collaboration with other FAP experts including
the FAP co-developers). The scale includes four items measuring “generalized repertoires” of
awareness, courage, love, and behavioral theory. Eight items measure specific competencies
(assessing CRB, evoking CRBs, appropriate self-disclosure, responding to problematic client
behavior [“CRB1s”], responding to improved client behavior [“CRB2s”], tracking impact of
therapist’s attempts to use reinforcement, providing and shaping functional interpretations
[“CRB3s”], and implementing generalization through homework assignments) that map onto the
five principal FAP rules (Kohlenberg &; Tsai, 1991). Trained coders score recorded therapy
sessions using a four point scale (0=no indication of the behavior at all in the session; 3=a full,
highly competent repertoire displayed in the session). The minimum threshold for FAP
competency is set at a score of 2. Since CRBs are idiographically defined based on the case
conceptualization, the FAPCS is ideally used when the case conceptualization is provided;
however, the FAPCS can be scored without a case conceptualization.
FAP Vignettes (Kanter et al., 2013).
Description: Two brief vignettes are presented followed by prompts for open-ended responses by
trainees. Two items are based on the first vignette, which is a 13 line transcript in which a client
expresses nervousness in response to a therapist’s question. Item one asks trainees to give a FAP-
informed therapist response to the client’s nervousness. Item two asks trainees to provide a brief
FAP rationale to the client. The second vignette presents a single client utterance that trainees are
told to assume represents a clinical improvement (CRB2). The third item measures the extent to
which trainees offer a FAP-consistent response to this CRB2. Items are scored an academic scale
ranging from an F to an A+, which is converted to a numerical scale (F = 0 to A+ = 12) to permit
statistical comparison. The three items are averaged to provide an overall score. Reliability
assessed by a second coder was high (ICCs ranging from 0.88-0.91 for the items).
FAP Impact Scale (FAPIS) (Kanter et al., 2012).
Description: The FAPIS is a self-report scale with 46 items measuring the impact of FAP
training on trainees. A sample item is “I say things that are hard to say to my clients.” Items are
scored on a 7-point scale (1=”disagree strongly, 4=””neutral/mixed”, 7=”agree strongly”).
Kanter et al. (2012) describe pilot data on the reliability and validity of the scale with two
cohorts (n=10 each) of graduate students. In the study, FAPIS total score had internal
consistency α=0.94.
FAP Rating Scale (FAPRS)(Callaghan & Follette, 2008; Callaghan & Ruckstuhl, 2000;
Callaghan et al. 2005; Callaghan et al., 2008)
Description: The FAPRS is a manualized coding system that categorizes client and therapist
statements (turns) on a turn-by-turn basis based on the functional (rather than topographic)
properties of the statements. Callaghan and Follette (2008) state that the FAPRS is “designed to
be functional, or at least quasi-functional with respect to the codes that are assigned to each
client or therapist behavior.” (p. 62). Coders assess the apparent functions of a statement based
on an established FAP case conceptualization. Therefore, the same statement made in a different
client-therapist dyad may be coded differently based on the specific case conceptualization for
each client. Callaghan and Follette (2008) described seven possible codes for client statements
(e.g., CRB2 is a clinically relevant behavior that reflects an in session improvement per the case
conceptualization). Therapist statements are categorized as one of 15 possible codes. Coders are
instructed not to code what the therapist attempts to do but rather whether those attempts are
successful or not. In some applications of the FAPRS, certain codes are combined or omitted for
strategic analytic purposes. A coding hierarchy establishes the priority rules when a statement
appears to contain more than one codable response. For example, if a turn reflects both
problematic in-session behavior and improved in-session behavior, it would be coded as an
improved in-session behavior (CRB2). Since the functional impact of a statement needs to be
assessed in context of the behavior that precedes and follows it, certain codes require an
appropriate antecedent behavior (e.g., a therapist effectively responding to a CRB1, coded as
TCRB1, can only occur in response to a client’s CRB1). To identify the function of a response,
coders can consider the six turns (three statements by the client, three by the therapist) that
follow a statement before deciding how to code that statement.
Therapist In Session Strategies Scale (THISS) (Kohlenberg et al., 2002; Parker, 2006; Parker
et al., 1996)
Description: The THISS consists of 36 items that are divided into four content subscales:
Cognitive Therapy, In Vivo Cognitive Therapy, FAP, and Interpersonal Therapy. The FAP
subscale measures in vivo interventions specific to FAP (e.g., therapist disclosure of thoughts or
feelings about the client’s in vivo behavior).
FAP Adherence Scale (Maitland & Gaynor, 2016)
Description: The FAP Adherence Scale is a 10 item measure with four items comprising a
supportive listening subscale, five items related to application of FAP rules comprising a FAP
subscale, and one item measuring homework assignment. Items 1-9 are scored from 0 (did not
occur) to 3 (occurred three or more times). The homework item is scored as 0 (did not occur, 1
(partial) or 2 (occurred).
Functional Assessment of Skills for Interpersonal Therapists (FASIT) (Callaghan, 2006b)
Description: The FASIT is a detailed manual describing five general classes of interpersonal
behavior that are proposed to be critical for effective interpersonal therapies, particularly FAP.
The manual describes several examples in each class and provides guidance for a trainee or
supervisor to discriminate effective from ineffective therapist behaviors. An appendix includes
idiographic measures of behavior that therapists may be targeting in their own repertoires.
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