Dysfunctional control by client verbal behavior: The context of reason-giving
Open accessAbstract
Dysfunctional control exerted by reason-giving in adult psychopathology is interpreted from a radical behavioral perspective. Verbal-social contingencies which support the establishment of reason-giving and its control over maladaptive actions are reviewed. A contextual approach to psychotherapy, comprehensive distancing, which attempts to weaken dysfunctional verbal control is described briefly. Data relevant to therapeutic process are presented. The overall results suggest that comprehensive distancing facilitates therapeutic change through a process consistent with a behavioral analysis of reason-giving. Suggestions for further research and radical behavioral approaches to psychotherapy are discussed.
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Believability of depressive thoughts mediated outcomes in ACT but not in CT.
“Believability of depressive thoughts mediated outcomes in ACT but not CT (Hayes et al., 2006; Zettle & Hayes, 1986);”
From Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy (2013) · cites this paper as Zettle & Hayes, 1986
The ATQ section reports a larger reduction in depressive-thought believability with comprehensive distancing than with cognitive therapy, and Related Research reports better depression outcomes for the distancing group. But the paper does not show that believability mediated outcomes in either group; it also reports that believability declined in both groups. The claim turns a tentative account of differing processes into a specific mediation finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSome studies show mediation using processes assessed before outcome differences appear, while in other cases mediators were assessed concurrently with outcome.
“For example, some studies show mediation using processes assessed before outcome differences are seen (e.g., Gifford et al., 2004; Lundgren et al., 2008; Zettle & Hayes, 1986, as reanalyzed in Hayes et al., 2006); in other cases the mediators were assessed concurrently with outcome.”
From Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy (2013) · cites this paper as Zettle & Hayes, 1986
In Related Research, the paper reports a significant depression-outcome difference at follow-up; in ATQ, it reports a significant difference in thought believability at posttreatment. That supports the stated ordering of process and outcome differences for this study. The paper calls its process findings tentative, however, and does not report a mediation analysis; the cited reanalysis cannot be assessed from this paper's text. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe first two published ACT outcome studies directly compared ACT with cognitive therapy.
“The first two published ACT outcome studies involved a direct comparison of ACT to cognitive therapy (CT; Zettle & Hayes, 1986; Zettle & Raines, 1989).”
From Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy (2013) · cites this paper as Zettle & Hayes, 1986
The Related Research section describes a direct comparison of comprehensive distancing with two variants of cognitive therapy and briefly reports outcomes. It does not call the intervention ACT or establish that this and the separately cited study were the first two published ACT outcome studies; it says fuller outcome data would be presented elsewhere. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAn ACT treatment group with depression demonstrated the most improvements in depression compared with cognitive restructuring alone and cognitive restructuring plus distancing.
“Zettle and Hayes found that the ACT treatment group that contained patients with depression demonstrated the most improvements in depression compared with cognitive restructuring alone and cognitive restructuring plus distancing group [48].”
From ClearMind Workshop: An ACT-based Intervention Tailored for Academic Procrastination among Computing Students (2024) · cites this paper as [48]
In Related Research (page not given), the paper reports that clinically depressed women received comprehensive distancing, cognitive restructuring alone, or cognitive restructuring plus distancing, and that the comprehensive-distancing group showed the greatest improvement in interviewer-rated depression. It calls the treatment “comprehensive distancing,” not ACT, and combines the two cognitive-therapy groups for its reported outcome comparison rather than establishing a separate result against each one. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn Zettle and Hayes (1986), ACT and CT did differ significantly when clients rated the believability of their depressogenic thoughts were they to occur (ATQ-B), a measure of cognitive defusion.
“but did if clients were asked to rate the believability of these same thoughts were they to occur (the ''ATQ-B'')-a measure of cognitive defusion.”
From Acceptance and commitment therapy: model, processes and outcomes (2006) · cites this paper as Zettle and Hayes (1986)
The ATQ section (page not available in our copy) reports significantly lower posttreatment ATQ-B believability scores for comprehensive distancing than for cognitive therapy (U = 12.5, p < .05). The paper calls the treatment comprehensive distancing, not ACT, and does not identify ATQ-B as a measure of cognitive defusion. Its reported follow-up difference was not statistically significant. (LLM, conf=0.85)
Experimental — accuracy not yet measured
In Zettle and Hayes (1986), ACT was superior to CT on depression outcomes at post and at a 2-month follow-up.
“ACT was superior to CT on depression outcomes at post and at a 2-month followup.”
From Acceptance and commitment therapy: model, processes and outcomes (2006) · cites this paper as Zettle and Hayes (1986)
The Related Research section (page unavailable) reports that comprehensive distancing produced larger reductions in interviewer-rated depression than cognitive therapy and significantly lower Hamilton depression scores at the two-month follow-up. It does not establish a between-group advantage on depression outcomes at posttreatment, and it calls the intervention comprehensive distancing rather than ACT. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe individual studies reviewed in the meta-analyses spanned from 1986 to 2018.
“The individual studies that were reviewed in the meta-analyses spanned from 1986 (Zettle & Hayes, 1986) to 2018 (Gr ´ egoire, Lachance, Bouffard, & Dionne, 2018).”
From The empirical status of acceptance and commitment therapy: A review of meta-analyses (2020) · cites this paper as Zettle & Hayes, 1986
ACT is effective for various clinical and mental health conditions.
“ACT is known to be an effective intervention for various clinical and mental health conditions [4,9,11,16,41,48,49].”
From ClearMind Workshop: An ACT-based Intervention Tailored for Academic Procrastination among Computing Students (2024) · cites this paper as [48]
The Related Research section reports improvement among clinically depressed women receiving comprehensive distancing, and the Summary and Conclusions describes that evidence as tentative. Our copy does not identify comprehensive distancing as ACT or address ACT’s effectiveness across various clinical and mental health conditions (searched for ACT and broader treatment outcomes). (LLM, conf=0.76)
Experimental — accuracy not yet measured
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“Previous research has successfully shown the mediational effect of cognitive fusion measures in other settings (Bach & Hayes, 2002; Zettle & Hayes, 1986), and in a previous study, this specific measure partially mediated the effects of ACT on burnout outcomes (Hayes, Bissett, et al., 2004).”
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Self-citationThe Drexel defusion scale: a new measure of experiential distancing
Forman, E. M., Herbert, J. D., Juarascio, A. S., Yeomans, P. D., Zebell, J. A., Goetter, E. M., & Moitra, E. (2012) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2012.09.001 · Cited by 117 · see citing works
Forman, E. M., Shaw, J. A., Goetter, E. M., Herbert, J. D., Park, J. A., & Yuen, E. K. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.04.004 · Cited by 113 · see citing works
Herzberg, K. N., Sheppard, S. C., Forsyth, J. P., Credé, M., Earleywine, M., & Eifert, G. H. (2012) · Psychological Assessment · doi:10.1037/a0027782 · Cited by 113 · see citing works
Petersen, C. L., & Zettle, R. D. (2009) · The Psychological Record · doi:10.1007/bf03395679 · Cited by 108 · see citing works
Self-citationHandbook of Homework Assignments in Psychotherapy
Kazantzis, N., & L’Abate, L. (2006) · Springer eBooks · doi:10.1007/978-0-387-29681-4 · Cited by 106 · see citing works
A Behavior-Analytic Account of Depression and a Case Report Using Acceptance-Based Procedures
Dougher, M. J., & Hackbert, L. (1994) · The Behavior Analyst · doi:10.1007/bf03392679 · Cited by 106 · see citing works
Hayes, S. C. (2008) · Clinical Psychology: Science and Practice · doi:10.1111/j.1468-2850.2008.00139.x · Cited by 104 · see citing works
Self-citationFolke, F., Parling, T., & Melin, L. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.01.002 · Cited by 100 · see citing works
Traduction et validation française du questionnaire d’acceptation et d’action (AAQ-II)
Monestès, J.-L., Villatte, M., Mouras, H., Loas, G., & Bond, F. W. (2009) · European Review of Applied Psychology · doi:10.1016/j.erap.2009.09.001 · Cited by 100 · see citing works
Kanter, J. W., Baruch, D. E., & Gaynor, S. T. (2006) · The Behavior Analyst · doi:10.1007/bf03392129 · Cited by 96 · see citing works
Wicksell, R. K., Dahl, J., Magnusson, B., & Olsson, G. L. (2005) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(05)80069-0 · Cited by 95 · see citing works
Metacognitive processes model of decentering: emerging methods and insights
Bernstein, A., Hadash, Y., & Fresco, D. M. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.01.019 · Cited by 95 · see citing works
Radical behavioral psychotherapy: Two contemporary examples
Kohlenberg, R. J., Hayes, S. C., & Tsai, M. (1993) · Clinical Psychology Review · doi:10.1016/0272-7358(93)90047-p · Cited by 96 · see citing works
Self-citationGaudiano, B. A., Herbert, J. D., & Hayes, S. C. (2010) · Behavior Therapy · doi:10.1016/j.beth.2010.03.001 · Cited by 91 · see citing works
“From the earliest ACT studies, believability of thoughts as distinct from their occurrence has been used as a convenient proxy for defusion (e.g., Zettle & Hayes, 1986).”
MethodResultSelf-citationMasuda, A., Hayes, S. C., Twohig, M. P., Drossel, C., Lillis, J., & Washio, Y. (2009) · Behavior Modification · doi:10.1177/0145445508326259 · Cited by 89 · see citing works
Self-citationHandbook of Brief Cognitive Behaviour Therapy
(2001) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa.2001.06214dae.012 · Cited by 90 · see citing works
Karlin, B. E., Walser, R. D., Yesavage, J., Zhang, A., Trockel, M., & Taylor, C. B. (2013) · Aging & Mental Health · doi:10.1080/13607863.2013.789002 · Cited by 89 · see citing works
Bennett, M. P., Knight, R., Patel, S., So, T., Dunning, D., Barnhofer, T., Smith, P., Kuyken, W., Ford, T., & Dalgleish, T. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01397-5 · Cited by 81 · see citing works
Behavior analysis and the social construction of knowledge.
Guérin, B. (1992) · American Psychologist · doi:10.1037//0003-066x.47.11.1423 · Cited by 86 · see citing works
'Third wave' cognitive and behavioural therapies versus treatment as usual for depression
Churchill, R., Moore, T. H., Furukawa, T. A., Caldwell, D. M., Davies, P., Jones, H., Shinohara, K., Imai, H., Lewis, G., & Hunot, V. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008705.pub2 · Cited by 82 · see citing works
A psychological flexibility -based intervention for Burnout:A randomized controlled trial
Puolakanaho, A., Tolvanen, A., Kinnunen, S. M., & Lappalainen, R. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.11.007 · Cited by 82 · see citing works
Bolling, M. Y., & Kohlenberg, R. J. (2004) · Psychotherapy and Psychosomatics · doi:10.1159/000080392 · Cited by 74 · see citing works
Bach, P., Gaudiano, B. A., Hayes, S. C., & Herbert, J. D. (2013) · Psychosis · doi:10.1080/17522439.2012.671349 · Cited by 73 · see citing works
Self-citationHayes, S. C., & Plumb, J. C. (2007) · Psychological Inquiry · doi:10.1080/10478400701598314 · Cited by 70 · see citing works
Sander, A. M., Clark, A. N., Arciniegas, D. B., Tran, K., Leon-Novelo, L., Ngan, E., Bogaards, J., Sherer, M., & Walser, R. (2021) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2020.1762670 · Cited by 68 · see citing works
Psychotherapies for adult depression: recent developments
Cuijpers, P. (2015) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000121 · Cited by 64 · see citing works
Experiential Avoidance, Acceptance, and Depression in Dementia Family Caregivers
Spira, A. P., Beaudreau, S. A., Jimenez, D., Kierod, K., Cusing, M. M., Gray, H. L., & Gallagher-Thompson, D. (2007) · Clinical Gerontologist · doi:10.1300/j018v30n04_04 · Cited by 64 · see citing works
Bramwell, K., & Richardson, T. (2018) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-017-9367-6 · Cited by 65 · see citing works
The role of cognition in complex human behavior: A contextualistic perspective
Hayes, S. C., & Wilson, K. G. (1995) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(95)00024-t · Cited by 61 · see citing works
Self-citationAvoiding and Altering Rule-Control as a Strategy of Clinical Intervention
Hayes, S. C., Kohlenberg, B. S., & Melancon, S. M. (1989) · Springer eBooks · doi:10.1007/978-1-4757-0447-1_10 · Cited by 63 · see citing works
Self-citationAcceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis
Tarbox, J., Szabo, T. G., & Aclan, M. (2022) · Behavior Analysis in Practice · doi:10.1007/s40617-020-00466-3 · Cited by 65 · see citing works
Juncos, D. G., & Markman, E. J. (2016) · Psychology of Music · doi:10.1177/0305735615596236 · Cited by 63 · see citing works
Some clinical implications of contextualistic behaviorism: The example of cognition
Hayes, S. C., & Hayes, L. J. (1992) · Behavior Therapy · doi:10.1016/s0005-7894(05)80383-1 · Cited by 63 · see citing works
Self-citationKanter, J. W., Callaghan, G. M., Landes, S. J., Busch, A. M., & Brown, K. R. (2004) · The Behavior Analyst Today · doi:10.1037/h0100041 · Cited by 63 · see citing works
Exploring cultural competence in acceptance and commitment therapy outcomes.
Woidneck, M. R., Pratt, K. M., Gundy, J. M., Nelson, C. R., & Twohig, M. P. (2012) · Professional Psychology Research and Practice · doi:10.1037/a0026235 · Cited by 60 · see citing works
Differential Strategies in Coping with Pain as a Function of Level of Experiential Avoidance
Zettle, R. D., Hocker, T. R., Mick, K. A., Scofield, B. E., Petersen, C. L., Song, H., & Sudarijanto, R. P. (2005) · The Psychological Record · doi:10.1007/bf03395524 · Cited by 60 · see citing works
Self-citationGaudiano, B. A. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.07.020 · Cited by 59 · see citing works
“Furthermore, the first small clinical trial comparing ACT versus cognitive therapy for depression was conducted in 1986 (Zettle & Hayes, 1986).”
The evolution of a contextual approach to therapy: From comprehensive distancing to ACT.
Zettle, R. D. (2011) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100929 · Cited by 59 · see citing works
Self-citationDalrymple, K. L., Fiorentino, L., Politi, M. C., & Posner, D. (2010) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-010-9145-1 · Cited by 58 · see citing works
A-Tjak, J. G. L., Morina, N., Topper, M., & Emmelkamp, P. M. G. (2021) · BMC Psychiatry · doi:10.1186/s12888-020-03020-1 · Cited by 57 · see citing works
Behavioral Cusps, Basic Behavioral Repertoires, and Cumulative-Hierarchical Learning
Hixson, M. D. (2004) · The Psychological Record · doi:10.1007/bf03395481 · Cited by 54 · see citing works
Mindfulness as a potential intervention for stimulus over-selectivity in older adults
McHugh, L., Simpson, A., & Reed, P. (2009) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2009.08.009 · Cited by 56 · see citing works
Moffitt, R., Brinkworth, G., Noakes, M., & Mohr, P. (2012) · Psychology & Health · doi:10.1080/08870446.2012.694436 · Cited by 51 · see citing works
Private events in behavior analysis: Conceptual basis and clinical relevance
Anderson, C. M., Hawkins, R. P., & Scotti, J. R. (1997) · Behavior Therapy · doi:10.1016/s0005-7894(97)80040-8 · Cited by 51 · see citing works
Waters, C. S., Frude, N., Flaxman, P. E., & Boyd, J. (2018) · British Journal of Clinical Psychology · doi:10.1111/bjc.12155 · Cited by 50 · see citing works
An Overview of Research on Acceptance and Commitment Therapy
Levin, M. E., Krafft, J., & Twohig, M. P. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.007 · Cited by 49 · see citing works
Bond, F. W., & Hayes, S. C. (2002) · Handbook of Brief Cognitive Behaviour Therapy · doi:10.1002/9780470713020.ch7 · Cited by 49 · see citing works
Self-citation301 Research topics from Skinner’s book Verbal Behavior
Sundberg, M. L. (1991) · The Analysis of Verbal Behavior · doi:10.1007/bf03392862 · Cited by 49 · see citing works
Rule-Governed Behavior: A Radical Behavioral Answer To the Cognitive Challenge
Zettle, R. D. (1990) · The Psychological Record · doi:10.1007/bf03399570 · Cited by 47 · see citing works
Self-citation
- Authors
- Zettle, R. D., & Hayes, S. C.
- Affiliations
- Wichita State University (US)
- University of North Carolina at Greensboro (US)
- Venue
- The Analysis of Verbal Behavior
- Published
- 1986-04
- Volume
- 4
- Issue
- 1
- Pages
- 30-38
- ISSN
- 0889-9401 (ISSN-L)
- 2196-8926
- PMC
- PMC2748463
- OpenAlex
- W1520147444
- Cited by
- 326
- References
- 41
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 10 · 2023: 5 · 2022: 13 · 2021: 12 · 2020: 10 · 2019: 9 · 2018: 11 · 2017: 17 · 2016: 13 · 2015: 25 · 2014: 16 · 2013: 21 · 2012: 20
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Analysis of Verbal Behavior (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- reason-giving, verbal control, radical behaviorism, maladaptive behavior, therapeutic change, adult psychopathology
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