Clinical Behavior Analysis, ACT and Case Formulation. A Commentary on Chapter “Case Formulation in Process-Based Therapies”

Acceptance and Commitment Therapy (ACT) is deeply rooted in Behavior Analysis. Some basic points of Behavior Analysis are worth highlighting: they are psychological flexibility, non-mentalistic assumption, functional analysis, values, and Process-Based Therapy. Psychological flexibility is a complex overarching repertoire of skills that allow clients to be willing to feel and think, to open themselves, with awareness, to the experience of the present moment and to direct their lives in ways that are important to them. Non-mentalistic assumption implies that ACT processes are behavioral patterns in context and should not be cognitivized. Functional analysis could be very helpful to assess the patient’s patterns of behavior that are out of touch with his or her present moment: many of our daily actions are in the form of routines and automatic behaviors that were useful and functional on many occasions, and therefore are maintained by strong contingencies of reinforcement, but can be very harmful and dysfunctional in different contexts. In ACT the term values refers to patterns of activities that give our lives meaning. Values are not goals. Goals can be accomplished while values help us to make choices based on the directions in which we want our lives to go but have no endpoint. Regarding the rise of Process-Based Therapy (PBT), this is really a new version of functional analysis integrated within multi-level, multi-dimensional evolutionary science.