An Introduction to Relational Frame Theory for Clinicians

1. An Introduction to Relational Frame Theory for Clinicians ACBS Annual World Conference VIII Reno, Nevada JT Blackledge, Ph. D. Morehead State University, Kentucky, USA Niklas Törneke, M. D. NT Psykiatri, Kalmar, Sweden

2. Structure for the workshop • Introduction • Functional contextualism • Basic behavioral principles • RFT in the lab • Main concepts in RFT and their general implications • RFT and clinical work (ACT) Blackledge/Törneke

3. Behavioral tradition Skinner and verbal behavior: An interpretative analysis based on animal research and general knowledge Two problems: • Noam Chomsky • A lack of an extensive research program Blackledge/Törneke

4. Cognitive tradition Hopythetical constructs as the answer: Mental representations, schema Two problems: • Central phenomena cannot be manipulated • Analysis of talking dissappeared when thinking was made the central issue Blackledge/Törneke

5. Clinical impact • Is everybody as good as everybody? • Does verbal behavior (cognition) matter? • What about going back to basic science for some answers? Blackledge/Törneke

6. Background Informationfor ACT & RFT • A full appreciation of what RFT has to do with ACT requires: • An understanding of functional contextualism • An understanding of basic behavioral principles • Including the continuity between the nature and purpose of these principles and the nature and purpose of RFT & ACT. Blackledge/Törneke

7. Functional Contextualism:The Philosophical Foundation for ACT & RFT

8. Stephen Pepper’s “World Hypotheses” • Described “relatively adequate” pre-analytic philosophical assumptions people make about (1) the goals of science and (2) the nature of knowledge. • Cast them as untestableassumptions • Matters of subjective opinion • Can’t run an empirical study to see whose opinions about the goals of science and the nature of knowledge are “wrong” and whose are “right”

9. Pre-Analytic Assumptions about Science • What is the goal of science? • Science is simply a systematic method for answering questions • The questions that “should” be asked are a matter of subjective opinion. Example: Grief • (A) “We should discover the various stages of grief people go through” • (B) “We should discover the best ways to help those in grief cope more effectively” • (C) “We should discover the neurological substrates of grief”

10. Pre-Analytic Assumptions about Science Metaphorical example: • “What should people do with their time on Earth?” • Help others? • Make money? • Raise a family? • Contribute to their community/country? • Follow a religion? • As with the question, “What is the goal of science?”, there are no purely objective, absolutely true answers to this question. • It’s a matter of opinion—of philosophical assumption.

11. Pre-Analytic Assumptions about Science • What is the nature of knowledge? • What is the nature of reality? • Can we come to know what “reality” is in an objective, complete, “T”ruth sense. • Or, can we only come to know relative or partial “t”ruths

12. Pre-Analytic Assumptions about Science • In other words, can human beings use science to discover absolute truth? • Or, might things like the following work to prevent this from happening: • Human perceptual errors & limitations • Measurement error • Errors in data interpretation • The effects that observation have on what is being observed • Failure to observe a phenomenon in multiple contexts

13. What kinds of ‘pre-analytic philosophical assumptions’ are there? • Pepper described 4 “relatively adequate” world views: • Contextualism • Formism • Mechanism • Organicism • Not the only possible world views…. • We’ll discuss mechanism and contextualism

14. Mechanism • Dominant set of philosophical assumptions held by scientist • Indeed, some would say there is no other approach to science • Core assumption: Human beings are like machines • They are made up of a variety of parts, each with its own task. • Various environmental or other forces move through the machine and exert an effect.

15. Mechanism • Mechanisms = “elemental realism” • The goal of science is to: • Determine what these parts are & how they interact • Determine how various forces (variables) impact the functioning of the machine. • Once we know exactly how the machine works and how various forces affect it, we’ll be able to fix the machine when it breaks, or help keep it working, but…… • Building comprehensive & accurate causal models that describe the machine’s functioning takes precedence.

16. Mechanism • Truth Criterion = How do we know when a theory is correct? • Mechanism = Truth by Correspondence • i.e., correspondence to “Reality” • Determined primarily by building causal models (theories) that perfectly predict what will happen in increasingly complex experiments. • Examples?

17. Contextualism • Human behavior can only be understood in context. • You must be able to understand an organism’s learning history and the current context surrounding the behavior of interest in order to understand why the behavior is occurring and what can be done to change or maintain it.

18. Contextualism • Because behavior can only be “understood” in context, all knowledge is relative. • Truth Criterion = Certainly not correspondence—Context issue makes “truth” relative. • Prediction & Control (Functional Contextualism) • Description (Descriptive Contextualism)

19. Contextualism • Assumptions behind contextualism: • The “Real” world probably cannot be accurately & completely captured by any theory • Too complex • Humans too limited in perceptual & analytic abilities • Humans systematically biased

20. Contextualism • Assumptions behind contextualism: • There is “One world”. • Theories and their “causal” models are simply tentative ways of talking about human behavior that should be held lightly & that do not accurately describe “reality” • Theories are useful to the extent that they facilitate achievement of the theorizer’s explicit goals • Prediction & control; description

21. Contextualism • Descriptive Contextualism • Archaeology • History • Kantor’s “Interbehaviorism” • Functional Contextualism • Relational Frame Theory (Acceptance & Commitment Therapy) • Conventional behaviorism, from some perspectives • Some modern feminist, sociological theories

22. Contextualism • “Prediction & control” softened to “prediction and influence. • What do you think of the ethical implications of making science be about “prediction & control/influence? • Consider also: Since contextualism does not subscribe to the notion of ‘absolute truth’, there is no ‘absolute grounding’ for any ethical principles one might attach to it. Does this complicate its ethical implications? Can these complications be circumvented? • E.g., ACT & Values

23. Contextualism • What misgivings do you have about contextualism & its implications?

24. Is Contextualism “Fishy” compared to Mechanism? • “Every theory ever invented by man is wrong. The theories that we currently subscribe to—we just don’t know how they’re wrong yet” (K. G. Wilson) Example: Ptolemy’s model of the solar system (100 AD) http://www.polaris.iastate.edu/EveningStar/Unit2/unit2_sub1.htm Used for 1500 years It was “wrong”—but you could predict the position of the stars and navigate by it!

25. Is Contextualism “Fishy” compared to Mechanism? Let’s harken back to a brief list of factors that can prevent a theory from ‘mapping onto reality’ before looking at what went wrong with Ptolemy’s theory: • Human perceptual errors & limitations • Measurement error • Errors in data interpretation • The effects that observation have on what is being observed • Failure to observe a phenomenon in multiple contexts

26. Is Contextualism “Fishy” compared to Mechanism? • Why was Ptolemy’s model of the solar system accepted as absolute truth for so long? It was a perfectly predictive model! • Accepted [Church; astronomers; navigators] dogma • It works and fits with “known” beliefs—therefore it must be absolute truth • Errors in data interpretation (model predicts the “movement” of the stars….when they apparently do not move) • Failure to study phenomena in multiple contexts (i.e., what would it look like if one had a ‘galaxy-eye view’?)

27. Is Contextualism “Fishy” compared to Mechanism? • Why was Ptolemy’s model of the solar system accepted as absolute truth for so long? It was a perfectly predictive model! • Measurement error: The stars weren’t exactly where the model predicted them to be (i.e., in terms of astronomical units), but there was not an accurate enough way of measuring this then. • Human perceptual errors & limitations: It looks like the stars are moving, so the model must be True! • Could it be that some of the same sources of error might confound the Absolute basis of virtually any theory?

28. Stephen Pepper’s “World Hypotheses” • Why is clarity about one’s philosophical assumptions about science & the nature of knowledge important? • Lack of clarity regarding one’s philosophical assumptions can lead to: • Unproductive (& unpleasant) arguments with other professionals regarding their methods, findings, & goals. • Incoherent focus in your professional work • Research that doesn’t satisfy your curiosity or further the development & testing of your theory • Therapy that is unfocused

29. Functional Contextualism & ACT • The nature of FC assumptions shine brightly in ACT: • What we think is just a way of describing or evaluating events---not the way. • Words don’t capture reality (or the ‘richness of experience’) • When one’s ‘theory’ (thoughts) helps you move toward your goals (values), listen to it; when it doesn’t, defuse. • Hold your theories (thoughts) lightly……. • Theories as metaphors…….and the risk of frozen metaphors

30. Functional Contextualism & RFT • And, as you’ll see, FC assumptions also shine brightly in RFT: • Just as a theory is a nonbinding way of talking about a set of phenomena, what we think--how we relationally frame our experiences--is simply a way of verbally conceptualizing those experiences. It is not a reflection of absolute Truth. • The usefulness of RFT as a theory depends on its ability to predict how people will think (relationally frame) under specific circumstances, and influence the impact those thoughts have on subsequent behavior.

31. The Nature & Goals of Behaviorism

32. The Nature & Goals of Behaviorism • Goals are highly pragmatic • Find ways of conceptualizing/speaking about human behavior that maximize or ability to predict & influence human behavior. • “Functional Contextualism” • Theory is “true” to the extent that it facilitates reliable prediction & control of behavior. • Assumption that human behavior is too complex (and the nature of human scientific inquiry too limited) to discover “Absolute Truth”.

33. The Nature & Goals of Behaviorism • Parsimony is King • The simplest explanation for human behavior is best. • Use an absolute minimum of principles/processes to predict and influence behavior • If these principles are proven insufficient, conservatively add new principles that do prove sufficient.

34. The Nature & Goals of Behaviorism • Theoretical principles should rely only on directly observable & directly manipulable behavior/stimuli • The introduction of unobservable “intervening variables” compromise parsimony. • You can’t directly manipulate an intervening variable • Compromises the “influence” part of “prediction and influence: A good functional contextual theory should be able to directly tell you exactly what to manipulate under various directly observable conditions.

35. Basic Behavioral Principles:Operant & Respondent Conditioning Blackledge/Törneke

36. What’s a Stimulus? • Anything you can perceive • Thought • Feelings • Sound, smell, sight, taste, physical sensation • Something said to you • The look on someone’s face • Memory • IF YOU RESPOND TO IT, IT’S A STIMULUS

37. What’s a [stimulus] function? • Typically used to refer to the type of consequence you receive for behaving in a certain way • If yelling serves an “attention function”, it means someone pays attention to you after you yell • If hiding serves an “avoidance function”, it means you avoid some type of aversive consequence by doing so • Can refer simply to what a stimulus “makes” you do • Automatic (conditioned) response: Food makes you salivate, a moving car makes you move out of the way…..a picture of G. W. Bush makes you wince.

38. Respondent (Classical)Conditioning

39. Respondent Conditioning:Basic Idea • Many stimuli naturally elicit (produce) an automatic response • Sight of food elicits a salivation response • An object moving toward your head elicits a ‘flinching’ or ‘ducking’ response • A physical attack during a war elicits anxiety • Sugar elicits the release of insulin into your bloodstream

40. Respondent Conditioning:Basic Idea • If you repeatedly pair a neutral stimulus with an “unconditioned” stimulus, the “neutral” stimulus can come to elicit the same response • Pavlov’s dogs: An audio tone can come to elicit salivation • The spoken word “duck” can come to elicit a “flinching” or “ducking” response • The sight of a soldier or loud sound can come to elicit anxiety • The sweet taste of a diet (or “light”) soda can come to elicit the release of insulin

41. Terminology • Unconditioned stimulus (US): • natural stimulus producing response • Unconditioned response (UR): • Unlearned or automatic response • Conditioned stimulus (CS): • originally a neutral stimulus--now elicits response that looks like an UR • Conditioned response (CR): • Response occurring to a CS that looks like an UR

42. Principle of Respondent Conditioning A neutral stimulus followed closely in time by a US, which elicits a UR, then the previously neutral stimulus will also tend to elicit the same response

43. Factors Influencing Respondent Conditioning • The greater the number of pairings of a CS with a US, the greater is the ability of the CS to elicit the CR • Stronger conditioning occurs if the CS precedes the US by about half a second, rather than by a longer time or rather than following the US • Conditioned taste aversion – exception to the rule • A CS acquires greater ability to elicit a CR if the CS is always paired with a given US than if it is only occasionally paired with the US.

44. Factors Influencing Respondent Conditioning When several neutral stimuli precede a US, the stimulus that is most consistently associated with the US is the one most likely to become a strong CS Respondent conditioning will develop more quickly and strongly when the CS or US or both are intense rather than weak

45. Higher Order Conditioning • 1st order • Pair NS and US to produce UR • CS will produce CR • EX: Pair bell and food to produce salivation; bell will produce salivation after conditioning • 2nd order • Pair NS and CS to produce CR • Produce a new CS which elicits the CR • EX: Pair light with bell to produce salivation; light will produce salivation after conditioning

46. Factors affecting conditioning • Stimulus generalization • Similar stimuli elicit CR • Stimulus discrimination • Respond to specific stimuli, but not similar ones

47. Operant Conditioning

48. Operant Conditioning Basic principle #1: Any behavior that is reinforced will occur more frequently. Anything that increases the frequency of a behavior is a reinforcer. Three term contingency: StimulusResponseReinforcer Or, AntecedentBehaviorConsequence (ABC)

49. Operant Conditioning Basic principle #2: Any behavior that is punished will occur less frequently. Anything that decreases the frequency of a behavior is a punisher. Three term contingency: StimulusResponsePunisher Or, AntecedentBehaviorConsequence (ABC)

50. Operant Conditioning: Reinforcement Many things can reinforce behavior: Things you say and do, food or other things you give them, attention, verbal or nonverbal approval, escape from demanding or unpleasant tasks, actions or activities and so on.