Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy

May combine two claims.

Evidence suggests relational skills are operant and impact all other behavioral processes, both operant and classical.

“Evidence suggests these relational skills are operant (e.g., Berens & Hayes, 2007), and that they impact all other behavioral processes, both operant and classical.”

• cites Berens & Hayes, 2007 sourceSupported

May combine two claims.

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);”

• cites Hayes et al., 2006 sourcePartly supported

  The Mediational studies section (p. 17) reports that changes in the believability of depressive thoughts mediated ACT’s superior outcomes relative to CT. It does not report a separate analysis showing that believability did not mediate outcomes within the CT group, so the “but not CT” portion is not established. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites Zettle & Hayes, 1986 sourcePartly supported

  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 measured

May combine two claims.

Some 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.”

• cites Gifford et al., 2004 sourceNot checked — no full text of the source
• cites Lundgren et al., 2008 sourceNot checked — no full text of the source
• cites Zettle & Hayes, 1986 sourcePartly supported

  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 measured

May combine two claims.

The Acceptance and Action Questionnaire broadly assesses experiential avoidance and psychological flexibility and predicts many forms of psychopathology well, as the model predicts.

“The Acceptance and Action Questionnaire (AAQ; Hayes et al., 2004; see Bond et al., in press, for a review of the AAQ II) assesses experiential avoidance and psychological flexibility fairly broadly and does a very good job of predicting many forms of psychopathology, as is predicted by the model (Hayes et al., 2006).”

• cites Hayes et al., 2004 sourceNot checked — no full text of the source
• cites Hayes et al., 2006 sourceSupported

May combine two claims.

The overall between-group effect size was d=.66 at post and d=.65 at follow-up.

“Overall the between-group effect size was d=.66 at post and d=.65 at follow-up.”

• cites Hayes et al., 2006 sourcePartly supported

  The 'Quantitative characterization of the relative strength of ACT outcomes' section (p. 15) reports an overall between-condition Cohen’s d of .66 at post, matching the claim. It reports .66—not .65—at follow-up. (LLM, conf=0.92)

  Experimental — accuracy not yet measured

May combine two claims.

In the 1980s, the authors conducted more than a dozen studies on theories behind common CBT procedures and found little or no support for those models.

“In the 1980s we conducted more than a dozen studies on the theories behind common CBT procedures, and found little or no support for these models (see Rosenfarb & Hayes, 1984, on cognitive reappraisal/self-statements for an example of these).”

• cites Rosenfarb & Hayes, 1984 sourceNot checked — no full text of the source

May combine two claims.

RFT researchers have found that a sense of locus derives from learning deictic relational frames such as I-you, here-there, now-then, and that these are central to perspective taking, empathy, and communication.

“RFT researchers have found that a sense of locus derives from learning “deictic relational frames,” such as “I–you,” “here–there,” and “now–then,” and that these are central to the ability to take the perspective of others, feel empathy, or to communicate (Rehfeldt & Barnes-Holmes, 2009).”

• cites Rehfeldt & Barnes-Holmes, 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Lappalainen et al. found that CBT increased self-confidence more than acceptance at post, while ACT showed the reverse.

“Lappalainen et al. found that CBT increased self-confidence more than acceptance at post, while the reverse was found for ACT.”

• cites Lappalainen et al., 2007 sourceNot checked — no full text of the source

May combine two claims.

In Lappalainen et al., both self-confidence and acceptance related to SCL-90 outcomes, but partial correlations eliminated self-confidence as a predictor.

“Both related to outcomes on the SCL-90 but if partial correlations with outcome were calculated for both, self-confidence no longer predicted outcome.”

• cites Lappalainen et al., 2007 sourceNot checked — no full text of the source

May combine two claims.

Öst criticized the lack of attention to syndromal diagnosis in the ACT literature, failing to note why that choice was made or the use of functional dimensional process information instead.

“For example, Öst (2008) criticized the lack of attention to syndromal diagnosis in the ACT literature, failing to note why this choice was made or to note the use of functional dimensional process information instead.”

• cites Öst, 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Interventions with even more challenging populations are currently being tested.

“Interventions with even more challenging populations (e.g., those with IQs below 70, brain-injured clients, young children, prisoners) are currently being tested.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

In the usual approach, philosophical assumptions are not explicated, basic processes are often an afterthought, and theories are generally narrow, vague, commonsense, and sometimes untested.

“In the usual approach, philosophical assumptions are not explicated, basic processes are all too often an afterthought, and if they exist at all theories are generally narrowly focused, vague, expressed in commonsense terms, and at times wholy untested.”

Probably not a substantial claim: may not pass S4 (based).

ACT and RFT are being developed by an open, diverse, nonhierarchical worldwide community of clinicians, scientists, scholars, and students.

“ACT and RFT are being developed by an open, diverse, nonhierarchical worldwide community of clinicians, basic scientists, applied scientists, scholars, and students.”

Probably not a substantial claim: may not pass S3 (load-bearing).

It is a value of the ACT/RFT development community to consciously limit hierarchy, isolation, and self-interest.

“It is a value of the ACT/RFT development community to consciously limit hierarchy, isolation, and self-interest.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Various considerations have led well-known and respected CBS researchers to call their protocols by other names at times.

“various considerations have led well-known and respected CBS researchers to call their protocols by other names at times (e.g., McCracken, 2005).”

• cites McCracken, 2005Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

As of late 2011, ACBS had nearly 4,000 members, more than half outside the United States.

“As of late 2011, ACBS had nearly 4,000 members, more than half outside of the United States.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

To the authors' knowledge, no progressive science has ever been built in such a fashion.

“To our knowledge, no progressive science has ever been built in such a fashion.”

May combine two claims.

Powers et al. entered disorder-specific distress as a primary outcome in their ACT meta-analysis, sometimes categorizing targeted behavioral outcomes as secondary.

“in their meta-analysis of ACT Powers et al. (2009) entered disorder-specific distress as a primary outcome, even at times categorizing targeted behavioral outcomes as secondary.”

• cites Powers et al., 2009 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Studies on ACT training have also been conducted.

“in addition to studies on training (e.g., Luoma et al., 2007).”

• cites Luoma et al., 2007 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

ACBS has eschewed certification of therapists.

“For example, ACBS has eschewed certification of therapists.”

Probably not a substantial claim: may not pass S3 (load-bearing).

There is no attempt to restrict those naming decisions in presentations accepted at ACBS conventions.

“There is no attempt to restrict those decisions in presentations accepted at ACBS conventions.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Junior researchers are often applauded or funded for mixing and matching techniques and syndromes and relabeling combinations as models, provided the combination is tested in a randomized trial.

“Junior researchers often are applauded (or at least funded) for mixing and matching techniques and syndromes like cooks in a kitchen, relabeling every combination as a model, approach, or treatment, provided only that in the end the technological stew is tested in the form of a randomized trial.”

Probably not a substantial claim: may not pass S2 (checkable).

Even serious scholars do not seem to understand the very different strategy followed by the CBS community.

“Even serious scholars do not seem to understand the very different strategy being followed by the CBS community.”

Probably not a substantial claim: may not pass S4 (based).

The usual idea seems to be that FDA-style medication validation can build a progressive field based on manualized treatments for well-specified syndromes validated in controlled studies.

“The idea seems to be that the Food and Drug Administration (FDA) style of medication validation can be used to build a progressive field based on manualized treatments focused on well-specified syndromes that are empirically validated in well-controlled studies.”

Classified as probably not a substantial claim.

The evidence for that claim is in the very list of matched CBT studies Öst created.

“The evidence for that claim is in the very list of matched CBT studies he created.”

May combine two claims.

Powers et al. entered pain intensity as a primary outcome of ACT chronic pain studies, and large effect sizes approached zero in some cases.

“Nevertheless, Powers et al. entered pain intensity as a primary outcome of ACT studies on chronic pain in their meta-analysis and large effect sizes suddenly approached zero in some cases.”

• cites Powers et al., 2009 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Whether protocols that comport with an ACT model are branded ACT is considered inside the CBS community to be a strategic decision, not a matter of fundamental importance.

“Whether protocols that comport with an ACT model are branded “ACT” is considered inside the CBS community to be a strategic decision, not a matter of fundamental importance”

May combine two claims.

The CBT list of studies was entirely on depression and anxiety, was well funded, contained no mediational analyses, and provided almost no process information.

“The CBT list of studies was 100% composed of studies on depression and anxiety, was funded well (77% with grants of more than $150,000), contained no mediational analyses, and provided almost no process information of any kind.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

ACT trainers are recognized through free peer review and must sign a values statement requiring protocols to be available free or at low cost and prohibiting proprietary entanglement.

“ACT trainers are “recognized” by a free process of peer review, and must sign a values statement in which protocols are made available for free or at low cost, and entanglement of ACT training with proprietary claims are prohibited.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

A domination of empirically validated technology over progressive theory is deeply embedded in contemporary empirical clinical thinking.

“but a domination of empirically validated technology over progressive theory is deeply embedded in contemporary empirical clinical thinking.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The resulting mountain of manuals and models is impossible to simplify or even characterize.

“The mountain of manuals and models that result is impossible to simplify or even to characterize.”

May combine two claims.

Öst compared the ACT literature with matched traditional CBT studies using traditional methodological standards, argued ACT was weaker, and failed to note evidence that ACT studies followed a different development model.

“He compared the ACT literature to a matched set of traditional CBT studies using a set of methodological standards drawn from a traditional model of development applied and argued that the ACT literature was weaker, but failed to note or explain the evidence that instead ACT studies were following a different model of scientific development.”

• cites Öst, 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The breadth of ACT research is undeniable, and RFT research is even broader.

“The breadth of ACT research is undeniable, and RFT is even broader.”

Classified as probably not a substantial claim. May combine two claims.

Acceptance and mindfulness techniques are entering new manuals rapidly, sometimes beside contradictory methods, without a well-crafted strategy for developing a real science.

“Acceptance and mindfulness techniques are now entering into new manuals at light speed, sometimes sitting side by side with seemingly contradictory methods, and without a well-crafted strategy in place for developing a real science out of this technological tangle.”

Probably not a substantial claim: may not pass S2 (checkable).

ACT and RFT researchers have been clear about their scientific development strategy.

“As we have tried to describe, ACT and RFT researchers have done so.”

Probably not a substantial claim: may not pass S2 (checkable).

Various ACT methods are argued to be the same or different, but the grounds for the argument seem to be appearances rather than well-crafted theory, data, or deep exposure.

“Various ACT methods are argued to be the same or different, but the grounds for the argument seem to be appearances, not well-crafted theory, data, or deep and broad exposure.”

Probably not a substantial claim: may not pass S4 (based).

Due in part to the dominance of the FDA model, ACT is most often approached as a collection of techniques evaluated only in terms of outcomes.

“Due in part to the dominance of the FDA model, ACT is most often approached as a collection of techniques evaluated only in terms of outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

On such a basis, a sophisticated CBT scholar can argue that ACT is the same as cognitive therapy and in the next breath that ACT is the same as an obscure Japanese treatment from the early last century.

“On such a basis, a sophisticated CBT scholar can argue that ACT is the same as cognitive therapy (Hofmann & Asmundson, 2008) and in the next breath argue that ACT is the same as an obscure Japanese treatment from the early part of the last century (Hofmann, 2008).”

• cites Hofmann & Asmundson, 2008 sourceNot checked — no full text of the source
• cites Hofmann, 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

The scientific progress of empirical clinical psychology seems mixed.

“The scientific progress of empirical clinical psychology seems mixed—no one claims that either paradise or failure has been achieved.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

So far, the vast majority of ACT critics have not explored ACT extensively, either experientially or intellectually.

“So far the vast majority of ACT critics have not explored ACT extensively, whether that is meant experientially or in the intellectual sense of a deep understanding of functional contextualism, RFT, and the CBS strategy of development.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

It would be unusual to evaluate an empirical clinical approach by examining the clarity of its philosophical assumptions, the adequacy and coherence of its basic behavioral principles, the integrity of its processes of change, the coherence and utility of its theory, and the consistency of the link between these and outcomes.

“It would be unusual to evaluate an empirical clinical approach by examining the clarity of its philosophical assumptions; by the adequacy, progressivity, and coherence of its basic behavioral principles; by the integrity of its processes of change; by the coherence and general utility of its theory; and by the consistency of the link between all of these and successful outcomes.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Although many ACT techniques are relatively distinct, many are shared with other approaches, especially within CBT but also with experiential, humanistic, and analytic traditions.

“Although many of the techniques in ACT are relatively distinct, many are shared with other approaches, especially within CBT writ large but also with experiential, humanistic, and analytic traditions.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The field is changing with the ascendance of mindfulness and acceptance-based approaches, whose core assumptions differ from traditional CBT assumptions.

“It seems clear that the field is changing with the ascendance of mindfulness and acceptance-based approaches and their core assumptions that differ so from traditional CBT assumptions.”

Classified as probably not a substantial claim.

The core unit of analysis in ACT's philosophy is the act in context: ongoing situated purposive action.

“The core unit of analysis adopted is the act in context: the ongoing situated purposive action (Hayes, 1993; Pepper, 1942).”

• cites Hayes, 1993Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Pepper, 1942Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

ACT researchers are skeptical of the view that CBT should apply a disorder-specific cognitive model or identify and logically test distorted cognitions.

“ACT researchers are skeptical of the idea that CBT needs to apply “the cognitive model of a particular disorder with the use of a variety of techniques designed to modify the dysfunctional beliefs and faulty information processing characteristic of each disorder” (Beck, 1993, p. 194) or that its core is to “identify distorted cognitions” and then to subject these distortions “to logical analysis”

• cites Beck, 1993 sourceNot checked — no full text of the source
• cites Clark, 1995 sourceNot checked — no full text of the source

May combine two claims.

ACT is a distinct and unified model of behavior change tied to a specific scientific development strategy called contextual behavioral science.

“The present article describes ACT as a distinct and unified model of behavior change, linked to a specific strategy of scientific development, which we term “contextual behavioral science.””

Probably not a substantial claim: may not pass S2 (checkable).

All actions are whole events whose meaning depends on their context.

“All actions are considered to be whole events, having meaning only with reference to their context.”

May combine two claims.

ACT belongs to the larger family of behavioral and cognitive therapies and has historically been presented as such.

“ACT is part of the larger family of behavioral and cognitive therapies (Forman & Herbert, 2009) and has always been said to be so (e.g., Hayes, Strosahl, et al., 1999, p. 79).”

• cites Forman & Herbert, 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Hayes, Strosahl, et al., 1999Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The change from behavior therapy to CBT addressed the right problem but adopted a suboptimal solution.

“The change from behavior therapy to CBT reflected the right problem but not the best solution.”

Classified as probably not a substantial claim.

ACT is an overarching model of intervention and change processes linked to research on language and cognition, a pragmatic philosophy of science, and a CBS development model.

“ACT is an overarching model of key intervention and change processes, linked to a research program on the nature of language and cognition, to a pragmatic philosophy of science, and to a model of how to speed scientific development that we call here a contextual behavioral science (CBS) approach.”

Classified as probably not a substantial claim. May combine two claims.

Functional contextualists assume one real world but allow many goal-dependent ways of successfully differentiating it.

“While functional contextualists assume the one (“real”) world, there may be many ways of successfully differentiating the world, depending on one’s goals.”

• AssumptionThe authors state this as an assumption: There is one real world.

May combine two claims.

From an ACT/RFT perspective, psychopathology is largely caused by entanglement in cognition, literal interpretation of thoughts, and persistence in problem-solving mode when it is unhelpful.

“From an ACT/RFT approach, psychopathology is caused in large part by the tendency to become entangled in cognition, taking thoughts literally and remaining in a problem-solving mode even when that is not helpful.”

May combine two claims.

Self-as-context interventions undermine excessive rule control and increase psychological flexibility.

“This in turn undermines excessive rule control and increases psychological flexibility.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The ability to move voluntarily from one domain of the present to another, or to persist in a focus when needed, brings attention under purposive control and expands what the present environment affords.

“The ability to move voluntarily from one domain of the present to another, or to persist in a focus when that is needed, is useful in bringing attention itself under purposive control and greatly expands what the present environment affords.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Acceptance is one of the biggest functional changes possible and often will ultimately change the form of emotional events themselves.

“Ironically, acceptance is one of the biggest functional changes possible, and often will ultimately change the form of emotional events themselves.”

Classified as probably not a substantial claim.

The CBS solution is to develop clinically useful models of pathology and treatment based on middle-level terms that are not behavioral principles but are based on them.

“The CBS solution to this conundrum is to develop clinically useful models of pathology and treatment based on middle-level terms that are not behavioral principles but are based on them.”

Probably not a substantial claim: may not pass S2 (checkable).

Acceptance is an intentional behavior that alters the function of inner experiences from events to be avoided to a focus of interest, curiosity, and observation as part of living a valued life.

“Acceptance is not passive tolerance or resignation but an intentional behavior that alters the function of inner experiences from events to be avoided to a focus of interest, curiosity, and observation as part of living a valued life.”

May combine two claims.

Behavioral principles are difficult to scale directly into clinical work, and early attempts to do so were abandoned.

“Behavioral principles are difficult to scale directly into clinical work, and early bold attempts to do so (Kanfer & Saslow, 1969) were long ago put aside.”

• cites Kanfer & Saslow, 1969Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S4 (based).

Cognitive, emotional, and behavioral inflexibility narrows the apparent opportunities to move in a valued direction.

“Cognitive, emotional, and behavioral inflexibility narrows the opportunities that are apparently present to move in a valued direction.”

Probably not a substantial claim: may not pass S4 (based).

Experiential avoidance is thought to greatly restrict behavioral flexibility and effectiveness.

“This is termed “experiential avoidance,” which is thought to enormously restrict behavioral flexibility and effectiveness.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The limits of perspective taking cannot be consciously known, providing a transcendent, spiritual aspect to human experience.

“The limits of perspective taking cannot be consciously known (e.g., you cannot consciously note the limits of consciousness) and thus provide a transcendent, spiritual aspect to human experience.”

Probably not a substantial claim: may not pass S3 (load-bearing).

RFT is leading to applied programs in many areas.

“RFT in turn is leading to applied programs in many areas.”

May combine two claims.

Word repetition reduces both believability and subjective distress from negative self-relevant phrases.

“ACT researchers have found that word repetition (Hayes, Strosahl, et al., 1999, pp. 154–156) reduces both believability and subjective distress experienced from negative self-relevant phrases (Masuda, Hayes, Sackett, & Twohig, 2004).”

• cites Masuda, Hayes, Sackett, & Twohig, 2004 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The ACT model is meant to be a user-friendly interface standing atop a more extensive enterprise.

“The ACT model is meant to be a kind of user-friendly interface—an operating system if you will—that stands atop a far more extensive enterprise.”

May combine two claims.

All complex organisms show avoidance learning, but in nonverbal organisms what is avoided are aversive stimuli, not reactions to them.

“All complex organisms show avoidance learning, but in nonverbal organisms what is avoided are aversive stimuli, not reactions to them.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Theoretically, all six ACT processes are related in all directions, though life histories, organismic patterns, and current situations strengthen or weaken these processes and their interrelations.

“Theoretically, it is argued that all six processes are related to each other in all directions, but specific life histories, organismic patterns, and current situations enhance or diminish these processes and their interrelationships.”

May combine two claims.

An inadequate analysis of cognition and complexity were sources of difficulty in scaling behavioral principles into clinical work.

“An inadequate analysis of cognition was one source of the difficulty but the other was complexity.”

Classified as probably not a substantial claim.

ACT promotes attending to what is present in a focused, voluntary, flexible fashion linked to one's values and purposes.

“ACT promotes attending to what is present in a focused, voluntary, and flexible fashion, linked to one’s values and purposes.”

Classified as probably not a substantial claim. May combine two claims.

The relational context determines how and when events are related; the functional context determines what functions will be transformed in a relational network.

“The relational context determines how and when events are related; the functional context determines what functions will be transformed in terms of a relational network.”

May combine two claims.

Teaching a person to add 'I am having the thought that ...' to a self-evaluation amplifies the cognitive network but in a way that diminishes automatic and unhelpful cognitive control.

“For example, teaching a person to add “I am having the thought that …” to a self evaluation such as “I’m bad” is indeed designed to amplify the person’s cognitive network (it is a relational context intervention) but in a way that diminishes automatic and unhelpful cognitive control (it is also designed to be a helpful functional context intervention).”

Classified as probably not a substantial claim.

Arbitrary applicability means that virtually any situation can evoke aversive emotions.

“Furthermore, arbitrary applicability means that virtually any situation can evoke aversive emotions, such as when a beautiful sunset makes a person sad because a person who passed away is not there to see it.”

May combine two claims.

ACT seeks to undermine attachment to a conceptualized self and to promote contact with a sense of self based on the 'I/here/nowness' of conscious experience.

“ACT seeks to undermine an attachment to a conceptualized self (our fused, evaluative stories about who we are) and to promote contact with a sense of self based on the “I/here/nowness” of conscious experience.”

May combine two claims.

The 'soldiers on parade' mindfulness exercise reduces subjective distress from an intrusive thought-provoking task and affects willingness to engage in the task again.

“The “soldiers on parade” mindfulness exercise (Hayes, Strosahl, et al., 1999, pp. 158–160) reduces subjective distress from an intrusive thought-provoking task (Marcks & Woods, 2005) and willingness to engage in the task again (Marcks & Woods, 2007).”

• cites Marcks & Woods, 2005 sourceNot checked — no full text of the source
• cites Marcks & Woods, 2007 sourceNot checked — no full text of the source

May combine two claims.

Self-as-context interventions help clients see inner experiences as distinct from consciousness as such, and thus not necessarily a threat.

“It is important in ACT in part because self-as-context interventions help clients see inner experiences as distinct from consciousness as such, and thus not necessarily a threat.”

May combine two claims.

Although cognitive fusion is not necessarily harmful, it becomes harmful when over-extended.

“Although fusion is not necessarily harmful, it becomes so when over-extended.”

Probably not a substantial claim: may not pass S4 (based).

Psychological inflexibility is argued to be at the core of most human suffering.

“The coming together of all of these processes is termed “psychological inflexibility,” which is argued to be at the core of most human suffering.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Acceptance appears to depend on defusion, since fully embracing private events is difficult when they are experienced as one evaluates them.

“Acceptance seems to depend upon defusion, for example, because it is hard to embrace private events fully if they are as we evaluate them to be.”

May combine two claims.

Experiential avoidance often works in the short term to reduce some discomfort but can have long-term negative effects.

“As RFT explains, experiential avoidance often works in the short term to reduce some discomfort, but can have long-term negative effects. This idea is supported in the larger literature (Baumeister, Zell, & Tice, 2007; John & Gross, 2004; Pennebaker & Chung, 2007) and by numerous studies on experiential avoidance per se (see Chawla & Ostafin, 2007, for a recent review).”

• cites Baumeister, Zell, & Tice, 2007Not checked — no full text of the source
• cites John & Gross, 2004 sourceNot checked — no full text of the source
• cites Pennebaker & Chung, 2007Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Using literal language to undermine literality is difficult and can easily increase entanglement in the name of understanding.

“Because of the nature of language itself, trying to undermine literality using literal language is difficult and can easily lead to more entanglement in the name of “understanding.””

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

People fail to maintain contact with a transcendent sense of self, so their behavior becomes dominated by a conceptualized sense of self.

“They fail to stay in contact with a more transcendent sense of self, allowing behavioral patterns to be dominated by a conceptualized sense of self instead.”

May combine two claims.

Relational context interventions can also be functional context interventions, and the two can conflict.

“Relational context interventions can also be functional context interventions and the two can easily conflict.”

May combine two claims.

This suggests less behavioral impact and more psychological flexibility in the presence of hallucinations and delusions.

“suggesting less behavioral impact and more psychological flexibility in the presence of hallucinations and delusions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Values measures are beginning to appear.

“Values measures are also beginning to appear (e.g., Lundgren et al., 2008; Wilson, Sandoz, & Kitchens, 2010).”

• cites Lundgren et al., 2008 sourceNot checked — no full text of the source
• cites Wilson, Sandoz, & Kitchens, 2010 sourceNot checked — no full text of the source

May combine two claims.

These interventions may reduce the dominant control of distress over subsequent behavior and allow more flexible responding in aversive contexts.

“suggesting these interventions may reduce the dominant control of distress over subsequent behavior and allow for more flexible responding in aversive contexts.”

Probably not a substantial claim: may not pass S2 (checkable).

Tight links are needed between theoretical constructs and the auxiliaries and conditions of measurement, so that empirical problems can be attributed to the theory rather than to the measure.

“There needs to be tight links between theoretical constructs and the auxiliaries and conditions of measurement, so that empirical problems can be attributed to the theory rather than to characteristics of the measure (Hayes, 2004).”

• cites Hayes, 2004 sourceNot checked — no full text of the source

May combine two claims.

Depressed individuals are less sensitive to emotional contexts and show less reactivity to both positive and negative emotional stimuli.

“For example, it is known that depressed individuals are less sensitive to emotional contexts and show less reactivity to both positive and negative emotional stimuli (Rottenberg, Gross, & Gotlib, 2005)”

• cites Rottenberg, Gross, & Gotlib, 2005 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Believability ratings are commonly used to assess defusion, and specific defusion questionnaires have emerged.

“Believability ratings are commonly used to assess defusion (e.g., Varra, Hayes, Roget, & Fisher, 2008) and specific defusion questionnaires have emerged (Wicksell, Renofalt, Olsson, Bond, & Melin, 2008).”

• cites Varra, Hayes, Roget, & Fisher, 2008 sourceNot checked — no full text of the source
• cites Wicksell, Renofalt, Olsson, Bond, & Melin, 2008 sourceNot checked — no full text of the source

May combine two claims.

ACT for persons with psychosis reduces self-reported positive symptoms less than treatment as usual, but patients are rehospitalized less, particularly those who admit to positive symptoms.

“Similarly, ACT for persons with psychosis reduces self-report of positive symptoms less than treatment as usual, but patients are rehospitalizated less—particularly those who admit to positive symptoms (Bach & Hayes, 2002)”

• cites Bach & Hayes, 2002 sourceNot checked — no full text of the source

May combine two claims.

Öst was not biased; the traditional vision of scientific development inside CBT had led to large expensive studies focused on a narrow set of problems with weak process knowledge and limited theoretical coherence.

“Öst was not being baised: that is, indeed, where the traditional vision of scientific development inside CBT had led us, with large and expensive studies excessively focused on a relatively narrow set of problems but with very weak process knowledge and limited evidence of theoretical coherence and progress.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The only way to test and further develop a putatively unified model is to apply it to topographically distinct populations understood through the model's functional dimensional processes.

“The only way to test and further develop a putatively unified model is to apply it to topographically distinct populations understood in terms of the functional dimensional processes specified by the model.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The failures of ACT so far appear theoretically sensible.

“The failures so far seem theoretically sensible (e.g., it makes sense that acceptance will not help with food cravings if the person is not dominated by food to begin with) but a lot remains to be learned.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The breadth of ACT and RFT research exists because of the strategic vision described.

“That breadth exists because of this strategic vision.”

Probably not a substantial claim: may not pass S2 (checkable).

Diversity and openness ensure a large range of ideas, settings, backgrounds, professions, and cultures and make blind spots easier to contact.

“Diversity and openness ensures that the range of ideas, settings, backgrounds, professions, and cultures brought to this development strategy is large and that blind spots can be more readily contacted, especially those held by developers and early explorers.”

• AssumptionThe authors state this as an assumption: In a CBS approach, all ideas and methods are contextually limited.

May combine two claims.

Technological knowledge alone gives no basis for dealing with new problems, no systematic means to develop new techniques, and no way to organize the field except under broad tribal labels such as CBT.

“Technological knowledge alone gives us no basis for dealing with a new problem or situation, no systematic means to develop new techniques, and no way to organize the field except under broad tribal labels such as “CBT” that are gradually becoming meaningless.”

Classified as probably not a substantial claim.

The APA planning committee for the next DSM concluded that reifying DSM-IV entities as diseases is more likely to obscure than elucidate research findings.

“The American Psychiatric Association planning committee for the next edition of the DSM (Kupfer, First, & Regier, 2002) concluded “Reification of DSM-IV entities, to the point that they are considered to be equivalent to diseases, is more likely to obscure than to elucidate research findings”

• cites Kupfer, First, & Regier, 2002Not checked — no full text of the source

Classified as probably not a substantial claim.

Creating a broad and diverse development community is a necessary feature of the CBS approach.

“The creation of a broad and diverse development community is a necessary feature of the CBS approach for three reasons.”

Probably not a substantial claim: may not pass S4 (based).

The inductive and broadly focused development strategy of CBS can be quite slow.

“First, the inductive and yet broadly focused development strategy of a CBS approach can be quite slow.”

Classified as probably not a substantial claim. May combine two claims.

It becomes difficult to assimilate disconnected bits of information, the field becomes an incoherent mass impossible to master and teach, and shallow analysis prevents other areas of science from relating to clinical techniques.

“It becomes “difficult to assimilate the mountain of seemingly disconnected bits of information that science-as-technology presents. The field becomes an incoherent mass, impossible to master and impossible to teach [and] the shallow level of analysis means that other areas of science cannot be related to clinical techniques” (Hayes, Strosahl, et al., 1999, p. 15).”

• cites Hayes, Strosahl, et al., 1999Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Community control over development avoids the problem that only developers or the anointed can add or subtract elements in labeled and certified empirically supported treatments.

“Finally, community control over development avoids the problem faced by labeled and certified empirically supported treatments linked to scientific development strategies based on adherence to validated manuals, namely, that only developers or the anointed have the power to add or subtract elements.”

Probably not a substantial claim: may not pass S2 (checkable).

Only many hands can mount such an agenda.

“Only many hands can mount such an agenda.”

Probably not a substantial claim: may not pass S2 (checkable).

Given the distant and high aspirations of CBS, flexibility and temporal extension of communitarian control are necessary.

“Given the distant and high aspirations of a CBS approach, the flexibility and temporal extension of communitarian control is necessary.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The expansive goals of the ACT/RFT community are fully consistent with Skinner's original vision.

“Those outside of the behavior analytic tradition are commonly worried about the expansive goals of the ACT/RFT community, but it is fully consistent with Skinner’s (1948) original vision.”

• cites Skinner, 1948Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Hierarchy, self-focus, and ossification may result and could slow long-term scientific progress.

“The hierarchy, self-focus, and ossification that may result could well slow long-term scientific progress.”

Probably not a substantial claim: may not pass S2 (checkable).

The field needs a development strategy linked to pragmatically useful processes and theory.

“The field needs a development strategy linked to pragmatically useful processes and theory”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Knowledge development in a CBS approach is embedded and horizontal.

“Knowledge development in such an approach is embedded and horizontal.”

Probably not a substantial claim: may not pass S2 (checkable).

Applying the model across varied noncentral features may help identify its boundary conditions in accounting for pathology and treatment course and outcome.

“Such an approach to treatment testing may allow researchers to more readily identify the boundary conditions of the model in accounting for pathology and specifying treatment course and outcome”

Classified as probably not a substantial claim.

A CBS approach implies that effectiveness, training, and dissemination research should begin early and be emphasized throughout.

“This suggests that effectiveness, training, and dissemination research should begin early and be emphasized throughout (Hayes, 2002).”

• cites Hayes, 2002 sourceNot checked — no full text of the source

• AssumptionRests on an assumption: From a pragmatic perspective, the truth of an analysis is found in its utility where it is applied.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Long-term scientific progress is key to defeating human suffering due to scientific ignorance, but it requires a strategy that works.

“Long-term scientific progress is the key to defeating such a difficult opponent, but that will take more than effort. It requires a strategy that works.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The level of technique is a moving target, and unless processes are understood, it is impossible to know when different techniques are truly different.

“The level of technique is a moving target and unless processes are understood, it is impossible to know when different techniques are truly different”

Probably not a substantial claim: may not pass S2 (checkable).

A more interesting way to compare approaches is to compare their assumptions, theories, evidence on processes of change, component evidence, and developmental strategy.

“A more interesting way to compare approaches, if comparisons are to be made, is to compare their assumptions, theories, evidence regarding processes of change, component evidence, and developmental strategy.”

Probably not a substantial claim: may not pass S2 (checkable).

This change is not an issue of label or school.

“This is not an issue of label or school.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The contextual behavioral science approach seems coherent, reasonable, and distinctive, and it has yielded a substantial body of work deserving consideration on its own terms.

“The contextual behavioral science approach seems coherent, reasonable, and distinctive, and it has now yielded a body of work that is substantial enough for it to deserve to be considered on its own terms.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Generational changes within a field provide opportunities for advancement and renewal.

“Generational changes within a field provide opportunities for advancement and renewal.”

Classified as probably not a substantial claim.

A statement about MBCT emphasizing changing awareness of and relationship to thoughts rather than thought content could have been stated by an ACT theorist with only the therapy name changed.

“The statement “unlike CBT, there is little emphasis in MBCT [mindfulness-based cognitive therapy] on changing the content of thoughts; rather, the emphasis is on changing awareness of and relationship to thoughts” (Segal, Teasdale, & Williams, 2004, p. 54) could have been stated by an ACT theorist without altering a single word other than the name of the therapy.”

• cites Segal, Teasdale, & Williams, 2004Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

ACT and traditional CBT are distinct models but part of the same family and share the same opponent: human suffering due to scientific ignorance.

“ACT and traditional CBT are distinct models but they are part of the same family and they share the same opponent: the human suffering that exists because of scientific ignorance.”

Probably not a substantial claim: may not pass S2 (checkable).

These opportunities may be wasted unless we think seriously about scientific development strategies likely to produce long-term progress.

“These may be wasted, however, unless we think seriously about the scientific development strategies that are most likely to produce long-term progress.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Whether ACT/RFT succeeds or fails does not depend on the success or failure of traditional CBT or any other area of empirical clinical science and practice.

“But whether it succeeds or fails depends not one bit on the success or failure of traditional CBT or any other area of empirical clinical science and practice.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Everyday language and commonsense understanding based on mainstream assumptions are too flexible for that exercise to work well.

“Everyday language and commonsense understanding based on mainstream assumptions is too flexible for that exercise to work well.”

Probably not a substantial claim: may not pass S2 (checkable).

In the long run, what seems most important are empirically supported processes and theories, not empirically supported packages, techniques, labels, or the monuments developers build around them.

“in the long run what seems most important are not empirically supported packages, techniques, or labels, and the monuments to immortality developers tend to build around them but empirically supported processes and theories (Rosen & Davison, 2003)”

• cites Rosen & Davison, 2003 sourceNot checked — no full text of the source

May combine two claims.

The meta-analysis was still reasonably supportive, but failure to characterize evidence in an ACT-consistent way contributed to the incorrect conclusion that ACT was only as effective as any alternative active treatment.

“The meta-anlysis was still reasonably supportive, but the failure to characterize evidence in an ACT-consistent way contributed to the incorrect conclusion that ACT was only as effective as any alternative active treatment (see Levin & Hayes, in press, for a re-analysis of their data set).”

• cites Levin & Hayes, in pressNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

The argument about the dominant strategy will be decided sociologically by junior researchers, theorists, and students choosing where to invest their life energy.

“Frankly, that argument will not be decided by established researchers—it will be decided sociologically by junior researchers, theorists, and students choosing where to invest their life energy.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Logically, that evidentiary basis would make cognitive therapy a form of Morita therapy.

“Logically, that evidentiary basis would make cognitive therapy a form of Morita therapy”