A Whole Lotta Predictions

Ok, I admit it. This is a bit of a mess.

I think there are perhaps hundreds of predictions that can be made from
ACT and RFT that are reasonably novel, and the ACT and RFT books contain
dozens of them. But they have never been all pulled together; and many new ones come up
every month.

Getting these in order is a project that is going to take a long time and a lot of people.
This process ont he website will have that in shape over time but in the meantime it seemed that a quick and dirty process would be worthwhile, so I challenged the list serves. This list, raw and unfiltered, is the result. Some of these ideas are great. Some seem off. And anyone was and is allowed to play. But it seemed more important to get people thinking than to get it right if "right" meant that some "leader" says "this is right."

If you have ideas, back up to the next highest level and add a child page and put yours out there!

- S

Steve Hayes

 

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Things from Mike Twohig

These are the places where ACT will be different than BT, CT, or CBT
in the treatment of OCD or possibly other anxiety disorders (I am
more on top of the OCD data):

1. ACT based exposure will result in a greater ability to engage in
daily activities (or have a higher quality of live score)

2. Cognitions will be less believable (greater decreases in scores
on TAF scale) in ACT

3. ACT will be more acceptable (lower drop-outs, higher scores on
acceptability measures) than traditional BT / CBT methods

4. Clients will be more willing to confront feared stimuli in ACT

5. Therapists will rate administering the ACT intervention as more
acceptable

6. ACt will get better results at FU, but not necessarily at post

7. CT/ CBT will result in greater decreases in obsession at post,
but maybe not at FU (ACT will decrease obsessions at FU, but not
necessarily at post)

8. Outcomes on the ACT side will be mediated by changes in
willingness, defusion, and ability to act in a valued direction with obsessions

9. ACT will do particularly well with really difficult cases –
possibly even ERP failures

10. Avoidance of obsessions will better predict severity of OCD than
severity of obsessions (although greater avoidance should predict
greater intensity)

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I'm not sure who did these. Could be me (Steve Hayes) ... sounds familiar

Challenging dysfunctional beliefs (Crel interventions) can at times increase their functional importance
(have a Cfunc effect)

You will be able to see the entangling impact of challenging dysfunctional beliefs
at the neurobiological level (e.g., laterization; more activation of verbal areas;
more stress hormones)

Cfunc manipulations will generally have a more positive impact than Crel interventions with
chronic psychological conditions

Crel interventions will have greatest impact in unfamiliar areas (e.g., clarifying values)
than in correcting familiar ones (e.g., struggles)

Measures of the ACT model (EA, fusion, inflexibility) will mediate the relationship between most forms existing of coping
and outcomes

You will see the effect of each of the elements of the ACT model (defusion, acceptance, values etc) at the
neruobiological level

You will get greater generalization across areas of struggle through ACT methods than
you will with traditional CT/CBT methods

ACT methods combined with traditional behavioral methods will be more effective generally than these behavioral methods alone

ACT will produce better effects with more severe and treatment resistant clients than will traditional CT/CBT methods; in
general that will not be true (or as true) with low intensity cases

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Elaborating relevant verbal networks will reduce the believability of problematic thoughts (e.g., delusional beliefs/irrational beliefs) more than will disputing/challenging the thoughts. (Patty Bach)

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'cognitive restructuring" will be demonstrated to work (when it does), via defusion and not belief/thought modification.

Frank Gardner

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in prospective studies (e.g. with adolescents), measures of EA and fusion (with negative OR POSITIVE beliefs about self) will predict onset mental health problems; similarly, measures of experience of self as context/transcendental self will predict resilience to upsetting life events.

janet wingrove [janetwingrove@gmail.com]

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Disruptions in a spoken sample may decrease pre-post therapy/pre-post
sessions (controlled for spoken samples w/o therapy).

Long-term decreases in ACT compared to other therapies (pre-post
therapy) may speak to a removal of a maintaining reinforcer as opposed
to a momentary disruption that might be seen in pre-post session
information.

ivancicmartin [martin.ivancic@jirdc.org]

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- (I'm working on) a comparison of CBT-biopsychosocial models and ACT/RFT models with a heavy weight on differences in ecological (and clinical) validity and functional outcome. Prediction: ACT/RFT models are more ecological valid, easier to translate in clinical interventions and have a better predictive validity on functional outcome criteria (planning to make a difference in 'solid' versus 'soft' outcome criteria to review research)

Marco Kleen
Health Psychologist, Pain team Univesity Center of Rehabilitation Groningen

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In end-of-the-year Jean Dixon fashion, I'll throw in a prediction:

Often therapy uses multiple exemplars to shape functional deictic framing.
Helping people frame their clinically-relevant, evaluative self-talk
occuring HERE and NOW as THERE and THEN will likely move the AAQ-2, some
measures of "pathology" and reduce defusion.

DJ Moran

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Some predictions I came to think of:

ACT will help individuals to develop more behavioral flexibility, which will mean:

> motor skills will be acquired faster in an ACT+instruction+exercise condition compared to an instruction+exercise condition

> motor skills will be performed more fluently and with less training in an ACT condition

> the reported diversity of emotional experience will increase

> the observed diversity of emotional expressions (e.g. measured with Ekman's FACS) will increase

> self-ratings of goal-orientation and value-orientation will show a decrease in goal-orientation and an increase in value-orientation (e.g. in disputes with others the frequency of looking at the relationship will increase while the frequency of striving to be right will decrease)

Sorry, if others already posted similar things. I did not go through all the emails of the last few days already.

Rainer Sonntag

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JoAnne Dahl

1. ACT short term treatment (cheaper because shorter time and less
staff needed compared to large multidisplinary staff) empowers the
individuals own motivation by means of values work and creates more
long lasting behavior change and less pliance (short term changes
that are rule governed).

2. ACT will in the short term produce lower ratings on quality of
life that will increase significantly by the one year follow-up.
Since people are so adaptable, the initial life quality ratings will
show an adaption to a low level and ACT (especailly with the values
work) works at supporting people to see the descrepancy between one's
valued living and how one actually lives today. That descrepancy can
be devasting and that shows up in the lower quality of life ratings
and it takes time to build back up a valued life if the person has
been living in experiential avoidance.

3. ACT treatment increases "acceptance" of "clean" pain
(unconditioned response of pain to aversive stimuli) as a normal and
important phenonmena to value. And distinquishes and challenges
"dirty" pain as the conditioned thoughts and avoidance behaviors it
is. In so doing, increases in acceptance will predict increase in
activity, life quality and function.

4. ACT will be more acceptable (lower drop-outs, higher scores on
acceptability measures)

5. Clients will be more willing to confront feared stimuli since they
are working in their context of values.

6. Therapists working with ACT and chronic pain will be less "burned
out" as compared to other CBT treatments because they will not have
to "coach" the clients thru exposure of feared, painful stimuli.

7. Better results at FU

8. ACT will not result in less reports of pain but in greater
acceptance and function. Acceptance will come first and mediate
greater results in quality of life and function at follow up.

9. Outcomes on the ACT side will be mediated by changes in
willingness, defusion, and ability to act with pain.

10. ACT will do well with prevention of pain and sick leave directly
at the work site and with very difficulty clients on long term sick
leave that have failed in other programs

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Ken Carpenter

I think some differences may appear under the following conditions:

1. individuals on the low end of the defusion continuum (or high end of the fusion continuum) should fair better in ACT than CBT.

(ACT directly targets this behavior thus should do a better job of building it into an individual’s repertoire comapred to CBT which does not explicitly shape it, but needs it to be established in order for individuals to test the validity of their cognitions *have to step outside a thought to evaluate it).

2. Defusion in the context of acceptance should produce greater behavioral flexibility than defusion in the context of testing content. This may be testable in both in treatment outcome and analogue/lab tests in which individuals are presented with distracter stimuli in the context of completing tasks and are given different techniques to cope with what comes up. (Steve * i think some of your lab studies on coping statements in the presence of aversive stimuli are a good starting framework for developing these kind of lab based process models). I would also predict the differences between the 2 contexts (acceptance vs challenge/test) to vary along the experiential avoidance continuum- greater group difference on the upper end (greater) EA continuum.

3. I think another area (need to think through this more) is the different predictions RFT makes concerning the stimulus control of deriving relations (thus proposing a more dynamic process and situational specific relating responses) versus the more static nature of schema. I may be wrong here, but I think a successful CBT intervention would be xpected to result in the alteration of schema - thus among those who are CBT successes * would there be a stance that resurgence should not occur since the relations having been stored and static are now changed? RFT/ACT is more likely to handle/predict resurgence even among those who are treatment responders.

RFT

Responding in accordance with a coherent relational network will take less time (on average) than responding in accordance with an incoherent network (subject, of course, to the usual caveats concerning individual histories).

Another one -- Relating derived relations will produce some of the same effects that have been observed for analogical reasoning (that might be in the review piece?).

RFT models of semantic relations, analogy, executive function tasks, perspective-taking and the like should produce neural effects that overlap to some degree with the effects observed in the mainstream neuro-cog literature.

Increasing the extent, flexibility, and fluency of relational frames,
relational networks, relating relations, relating relational networks, the transformation of functions, and contextual control over each of these, should impact positively on a variety of standard measures of human language and cognition.

Things posted to the Academy list in June

New things RFT does. RFT:

Provides new ways to do language training

Has lead to a new and increasingly empirically supported psychotherapy
(ACT) and to quite number of new psychotherapy techniques

Suggests how to establish a sense of self in children

Shows some of how to train children in "theory of mind"

Gives a process account of mindfulness

Predicts how many basic cognitive skills form

Predicts new ways to increase openness to new learning

Explains some of where psychological rigidity comes from

Leads to a new model of psychopathology

Suggests some of the core skills involves in language and its subskills such as analogy and metaphor

Shows why existing information processing research in specific areas (e.g., analogy) is flawed and show how to correct that flaw

Predicts new methods how to increase some intellectual abilities

Predicts new methods for how to increase motivation verbally

Predicts some new methods to decrease motivation verbally

Has lead to new ways we might assess current cognitive relations

Explains some of why cognitive fusion emerges, why it is harmful, and what to do about it

Explains some of why experiential avoidance emerges, why it is harmful, and what to do about it

Provides unexpected predictions about neurobiological responses to specific cognitive tasks

What happens to Crel and Cfun in RFT studies when you teach folks to apply defusion during testing, and or when you teach defusion, train, and then test? I am thinking of M Dougher's recent study with > or < relations with shock. I wonder whether defusion would alter the transformation, perhaps leading subjects to not rip off the shock electrodes in the context of > relation. I wonder whether defusion would strengthen or perhaps weaken Crel and/or Cfun. My guess is that it may result in more rapid learning of Crel, but knock out Cfun. This would be cool to show. Maybe someone has done this, but if not we really should cook up some experiments along these lines.

-j forsyth

1. Additional corollary hypotheses:
(A) Speed of acquisition of AARR during an REP task (i.e., number of trials needed to respond consistently correctly) will correlate significantly and inversely with verbal IQ. (can’t recall off hand if Denis O’Hora has already tested this specifically yet).
(B) This one would be a doozie to quantify and test, but it follows from RFT: Subjects presented with a novel metaphor who generate higher numbers of apt comparisons (especially in shorter amounts of time) will perform better (i.e., will respond correctly more frequently and given less training trials) in an REP task that assesses their ability to correctly derive relations after two previously trained frames are brought into coordination.
2. Additional corollary hypotheses:
(A) AARR in fully verbal subjects will fail to occur over time within an experimental context, given a consistent lack of reinforcement for AARR and/or consistent punishment of AARR within that context.
3. Additional corollary hypotheses:
(A) The same established verbal relation (e.g., A is similar to B, which is similar to C) can be shown to accompany different functional transformations across different experimental contexts.
(B) Identical functional transformations can be shown to be achieved through the training of different verbal relations.

J T

read some RFT-research on the change of psychological function of stimulus C by putting it in relation with A-B (sexual excitement, taste preference, mood). What if C is relationally framed with 2 different classes: A-B-C, and X-Y-C. And let's say A is experienced a bit negative, and X also a bit negative. Would C become experienced more negative, than when it's framed with only one class? This might be an operationalisation of multiple small life experiences leading to a larger reaction.

De Groot, Francis [francis.de.groot@fracarita.org]