Criticisms of ACT

Criticisms of ACT

Given the values of ACBS, there has been efforts from the beginning of the ACBS community to encourage responsible criticism, to give thoughtful critics a stage to speak to the group, of trying to respond thoughtfully in writing to knowledgeable critics, and of trying to resolve issues empirically where possible. Criticisms of ACT have appeared in published forms. The written criticisms of RFT (and to a lesser degree, functional contextualism) are extensive and in writing, as are the defenses. They can be found in the other sections of the website.

Self-Criticism

Part of the core of the ACT / RFT tradition is the openness to criticism, including self-criticism. At the LaSalle ACT Summer Institute (Philadelphia, 2005) James Herbert gave a really solid paper walking through many of the criticisms he knew about, under the title "Is ACT a fad?" He considers not just whether the criticisms are correct, but what those in the ACT / RFT community should do about them. You can look at that talk by clicking on the link below.

Published Criticisms and Responses: An Ongoing Conversation Below is a list of papers that have been published criticizing ACT as well as replies that have been published when available. If you know of other criticisms or replies please email us or add a child page to this page.

  • Corrigan, P. (2001). Getting ahead of the data: A threat to some behavior therapies. The Behavior Therapist, 24(9), 189-193.
This was the first strong criticism of ACT published. Corrigan argued that the ratio of non-empirical to empirical articles could be used to argue that third-wave CBT was ahead of its data.
A reply: Hayes, S. C. (2002). On being visited by the vita police: A reply to Corrigan. The Behavior Therapist, 25, 134-137.
The reply argued that the ratio of non-empirical to empirical articles could not be meaningfully used as a measure of getting ahead of data since there were many good reasons to write theoretical discussion pieces. Instead, actual claims that got ahead of the data had to be identified and none have been. Pat has been helpful to ACT researchers in various capacities over the years since that article.
  • Corrigan, P. (2002). The data is still the thing: A reply to Gaynor and Hayes. The Behavior Therapist, 25, 140.
  • Hofmann, S. G. (2008). Acceptance and Commitment Therapy: New Wave or Morita Therapy? Clinical Psychology, Science and Practice, 5, 280-285.
The theme of these two articles is that ACT and other mindfulness-based treatments is the same as CBT, and that ACT is the same as Morita Therapy. After these articles were written Stefan Hofmann was invited and funded to speak to the ACBS community in Chicago (2007). We had a great time in respectful dialogue. Read more about this criticism in non-peer-reviewed settings and the ensuing dialogue, click on the child page"ACT is Outright Taken from Morita Therapy" below.
  • Öst, L. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46(3), 296-321.
This article is in part based on proactive efforts by the ACBS community to encourage knowledgeable criticism. Lars-Goran Öst has been invited and funded to come to several ACT conferences beginning even before he was knowledgeable of ACT work, given that he was asked to play the role of an outside critic at the first World Conference in Linkoping, Sweden (2003). He was later also invited to London (2006), and Enschede, The Netherlands (2009), that last invitation coming after the article itself was available.
The theme of Lar-Goran's criticisms have been that ACT research has methodological weaknesses, and that it is not as well done as mainstream CBT research. The latter was based on a comparison of ACT studies with a matched set of traditional CBT studies. His conclusion is that ACT is not an evidence-based treatment.
Gaudiano reply: Gaudiano, B. A. (2009). Öst's (2008) methodological comparison of clinical trials of acceptance and commitment therapy versus cognitive behavior therapy: Matching apples with oranges? Behaviour Research and Therapy, 47, 1066-1070.
Öst reply: Öst, L. -G. (2009). Inventing the wheel once more or learning from the history of psychotherapy research methodology: Reply to Gaudiano's comments on Öst's (2008) review. Behaviour Research and Therapy, 47, 1071-1073.
Gaudiano rejoinder: Gaudiano, B. (2009b) Reinventing the Wheel Versus Avoiding Past Mistakes when Evaluating Psychotherapy Outcome Research: Rejoinder to Öst (2009). Brandon has replied again in a piece self-published online (in an attempt to keep the conversation flowing without the confines of the lengthy peer-review process).
The theme of the replies was that errors were made in Lar-Goran's matching and coding process, resulting in a distorted comparison, and that ACT studies are not weaker when resulting differences in population and funding are weeded out. Further, it is noted that ACT is already listed by APA as an evidence-based treatment. Lars-Goran admits that the two sets of studies are not matched in areas such as funding, and that APA lists ACT as evidence-based, but holds to his original views.
  • Arch, J. J., & Craske, M. G. (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms? Clinical Psychology: Science & Practice, 5, 263-279.
A reply: Hayes, S. C. (2008). Climbing our hills: A beginning conversation on the comparison of ACT and traditional CBT. Clinical Psychology: Science and Practice, 5, 286-295.
The theme of the response was that ACT is part of the CBT tradition, but it is not possible to compare intellectual similarities until CBT says what it is. Efforts of the authors to do so were argued to change long standing mainstream views, which explain some of why the two could be argued to be very similar. Both the critical article and response agreed that there were good empirical issues to be explored.
Reflective of the tone of this dialogue, several ACT researchers (Georg Eifert, John Forsyth, Steve Hayes, Mike Twohig) are doing work with Michelle Craske and her colleagues trying to study the issues raised. Michelle has been invited to speak at an ACBS World Conference. She was not able to come in 2009 but we hope to hear her in the future.
A reply: Levin, M., & Hayes, S.C. (2009). Is Acceptance and commitment therapy superior to established treatment comparisons? Psychotherapy & Psychosomatics, 78, 380.
Author response: Powers, M. B., & Emmelkamp, P. M. G. (2009). Response to ‘Is acceptance and commitment therapy superior to established treatment comparisons?’ Psychotherapy & Psychosomatics, 78, 380–381.
ACT researchers have critically examined the method of the meta-analysis and have published a response to the study, with a revised analysis. A counter response by Powers and colleagues is also available. We invited Paul Emmelkamp to come to Enschede but he could not ... we hope to get him to an ACBS conference in the future.

Replies to Critiques in General: Articles Describing the CBS Strategy Extensive reviews of the issued raised in this article are out or in press, but they are too extensive to simply call them "replies." The theme of the articles (which you can read by clicking the link above) has been to describe the ACT approach, its knowledge development strategy and to show its distinctive features.

Steven Hayes

Criticism: "ACT is Outright Taken from Morita Therapy"

Criticism: "ACT is Outright Taken from Morita Therapy"
In June 2008 list serve post to the Academy of Cognitive Therapy, Bob Leahy, 2008 President-Elect of ACBT, made this claim: "Moreover, the claim for a new, unique model of treatment made by ACT does not seem justified. As some of those on this Listserve know, many of the ideas and techniques that Hayes has advanced are directly taken from Morita therapy. And without attribution. See http://en.wikipedia.org/wiki/Morita_Therapy or http://www.clcma.com/morita1.htm Pay attention to the discussion about mindfulness, acceptance, character, values, etc. This was 1928. That's a long time ago. Does this remind you of anything? Is this a coincidence?" ****************** This is a response written by Steve Hayes (on 6/29/08): The claim is false. Maybe folks in recent years have added things that I am unaware of ... ACT is a vast community .... but I am certain that no concepts or methods in the formative work on ACT came from Morita whatsoever. I never heard of Morita therapy until well after the ACT model was developed and published. I am not sure when I first heard of it but I do recall that the person knew Japanese and told me that the English translations are not very accurate and they had been made too much like CBT by Westerners. That decreased my interest in reading the secondary sources. The methods I saw in the limited reading I did (e.g., keeping depressed folks in sensory deprivation, etc) it just seemed way too far away from our work to be useful, especially since I recall seeing no controlled data. We have cited Morita several times as being relevant to the ACT work, however. For example in Hayes, S. C., & Ju, W. (1997). The applied implications of rule-governed behavior. Chapter in W. O'Donohue (Ed.), Learning and behavior therapy (pp. 374-391). New York: Allyn & Bacon, we said: "Conversely, the more traditionally non-empirical approaches, like Gestalt (Perls, 1969) and Morita (Morita, 1929), may be more consistent with the basic behavioral literature on rule-governance." Rather than a dark vision of scientific theft the more plausible reason for the connection is that many traditions have gathered together things that seem to work, and some of these overlap to a degree with ACT. ACT is a more bottom up, Western science account but it has arrived at places other traditions inhabit to a degree. That is particularly true with just about any Eastern tradition since all you really need to overlap a bit with where ACT ended up is mindfulness (which always includes acceptance somewhere) and some kind of right action (values). Because of the history of development, ACT partitions these broad chunks into technical processes that are linked to a basic account. That quality is part of what distinguishes ACT from these traditions. ACT is a model linked to a basic theory, clear philosophy, and successful applied technology. In other words, what is most new about ACT is that it is part of contextual behavioral science, with all of the progressive features this brings.
Steven Hayes