Is ACT Just a Fad? Addressing the Critics James D. Herbert, Ph.D. Drexel University.
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Transcript of Is ACT Just a Fad? Addressing the Critics James D. Herbert, Ph.D. Drexel University.
Is ACT Just a Fad?Is ACT Just a Fad?Addressing the CriticsAddressing the Critics
James D. Herbert, Ph.D.James D. Herbert, Ph.D.
Drexel University Drexel University
Emergence of CriticismEmergence of Criticism
As ACT has moved into the mainstream, a As ACT has moved into the mainstream, a variety of criticisms have emerged from variety of criticisms have emerged from within the academic community within the academic community
As ACT becomes more popular, we can As ACT becomes more popular, we can anticipate even more criticism from even anticipate even more criticism from even more voices more voices
Common theme: ACT is merely the latest Common theme: ACT is merely the latest therapeutic fad to litter the mental health therapeutic fad to litter the mental health landscape landscape
Let’s outline the criticisms so far, Let’s outline the criticisms so far, examine them critically and examine them critically and honestly, and explore how we as honestly, and explore how we as a community may responda community may respond
Complaints about ACTComplaints about ACT
Overly-hyped claims; “getting ahead of Overly-hyped claims; “getting ahead of the data”the data”
Excessive enthusiasm among those Excessive enthusiasm among those interested; the C-wordinterested; the C-word
Grandiose visionsGrandiose visions Proselytizing; ACT as a “way of life.”Proselytizing; ACT as a “way of life.” Promotes “undue influence” by seeking to Promotes “undue influence” by seeking to
identify principles and technologies that identify principles and technologies that could be used to impact behavior without could be used to impact behavior without their explicit consenttheir explicit consent
More Criticisms…More Criticisms…
Experiential exercises in ACT training Experiential exercises in ACT training are coercive & manipulativeare coercive & manipulative
There’s “nothing really new” hereThere’s “nothing really new” here Premature dissemination to the Premature dissemination to the
public via self-help bookspublic via self-help books Both ACT and especially RFT are Both ACT and especially RFT are
plagued by obscurantist jargonplagued by obscurantist jargon
Getting Ahead of the DataGetting Ahead of the Data
Must examine Must examine evidential warrantevidential warrant of specific of specific claims claims
Ratio of theoretical to empirical papers isn’t a Ratio of theoretical to empirical papers isn’t a proxy. Nor are dreams/visionsproxy. Nor are dreams/visions
Some critics are clearly unaware of the data Some critics are clearly unaware of the data that exist; those who are correctly note that that exist; those who are correctly note that it’s limited, but don’t generally compare it’s limited, but don’t generally compare specific claims with evidencespecific claims with evidence
ACT proponents have in fact been ACT proponents have in fact been appropriately cautious in claims appropriately cautious in claims
Our response: Continue to be clear about Our response: Continue to be clear about specific claimsspecific claims
Excessive EnthusiasmExcessive Enthusiasm
Largely based on reactions to Largely based on reactions to listserv, and to reactions of some listserv, and to reactions of some professors to their students returning professors to their students returning inspired from workshopsinspired from workshops
But enthusiasm per se is only a But enthusiasm per se is only a problem if it interferes with critical problem if it interferes with critical thinking. Any evidence of this?thinking. Any evidence of this?
Our response: Make sure not to be Our response: Make sure not to be blinded by enthusiasmblinded by enthusiasm
The “C” word: Is ACT a Cult?The “C” word: Is ACT a Cult? ““Cult” label usually evoked by:Cult” label usually evoked by:
– A closed systemA closed system– a charismatic leadera charismatic leader– a strong profit motivea strong profit motive– financial and/or sexual exploitation of vulnerable financial and/or sexual exploitation of vulnerable
populationspopulations– a hierarchy of secretive levels to pass through in a hierarchy of secretive levels to pass through in
order to gain special knowledge or statusorder to gain special knowledge or status– intolerance of dissentintolerance of dissent
Such groups also:Such groups also:– challenge the status quochallenge the status quo– offer a grand visionoffer a grand vision– engender high levels of enthusiasmengender high levels of enthusiasm
Is ACT a Cult?Is ACT a Cult?
The first set of features don’t apply, The first set of features don’t apply, but the second set clearly dobut the second set clearly do
However, these latter features are However, these latter features are poor discriminators of science vs. poor discriminators of science vs. pseudoscience or cults pseudoscience or cults
Our response: This is silly; ignore itOur response: This is silly; ignore it
Grandiose VisionsGrandiose Visions Rightly or wrongly, ACT does indeed aspire to great Rightly or wrongly, ACT does indeed aspire to great
things things Helps to understand history of behavioral analysis to Helps to understand history of behavioral analysis to
appreciate the historical contextappreciate the historical context Critical to distinguish specific claims from distal Critical to distinguish specific claims from distal
goals/dreams; the former are subject to direct goals/dreams; the former are subject to direct examination via evidential warrant; the latter are notexamination via evidential warrant; the latter are not
Compare biotechnology conference last month in Compare biotechnology conference last month in PhiladelphiaPhiladelphia
Problem is that mainstream psycho-therapies are Problem is that mainstream psycho-therapies are cautious about big claims, whereas many dubious cautious about big claims, whereas many dubious ones are notones are not
Our response: Clarify explicitly the distinction Our response: Clarify explicitly the distinction between specific claims and distal visionsbetween specific claims and distal visions
Proselytizing ACT as a “Way of Life”Proselytizing ACT as a “Way of Life” Two variations: Clinicians must adopt an ACT Two variations: Clinicians must adopt an ACT
perspective to their own life, & the focus of the perspective to their own life, & the focus of the client’s presenting problem is inappropriately client’s presenting problem is inappropriately shifted to ACT-consistent goalsshifted to ACT-consistent goals
Although ACT does suggest that clinicians try out Although ACT does suggest that clinicians try out some principles on themselves, it doesn’t some principles on themselves, it doesn’t requirerequire them to adopt any particular belief systemthem to adopt any particular belief system
Re. clients, again this is not unique to ACT, as all Re. clients, again this is not unique to ACT, as all psychotherapies attempt to socialize the client to psychotherapies attempt to socialize the client to their model. The key in all cases is informed their model. The key in all cases is informed consentconsent
Our response: We could probably be clearer on Our response: We could probably be clearer on these pointsthese points
ACT Seeks “Undue Influence”ACT Seeks “Undue Influence” Familiar criticism to radical behavioristsFamiliar criticism to radical behaviorists Ethics surrounding parameters of informed consent Ethics surrounding parameters of informed consent
is an important cultural value, and like all values, is an important cultural value, and like all values, must be decided independent of science per semust be decided independent of science per se
Extreme Libertarian stance rules out all public Extreme Libertarian stance rules out all public health interventions (e.g., programs promoting health interventions (e.g., programs promoting smoking cessation, safe sex to prevent STDs, smoking cessation, safe sex to prevent STDs, routine diagnostic procedures like mammograms routine diagnostic procedures like mammograms and prostate exams, childhood vaccinations)and prostate exams, childhood vaccinations)
The fact that a technology could possibly be The fact that a technology could possibly be misused is no reason to stifle sciencemisused is no reason to stifle science
Our response: Participate in the broader public Our response: Participate in the broader public ethical dialogueethical dialogue
ACT Offers “Nothing New”ACT Offers “Nothing New”
Generally argued by those with minimal Generally argued by those with minimal familiarity with ACT. Ironically, CBT folks who familiarity with ACT. Ironically, CBT folks who make this argument have themselves been on make this argument have themselves been on the receiving end of this allegation from the receiving end of this allegation from psychoanalysts & others psychoanalysts & others
Many (though not all) techniques and strategies Many (though not all) techniques and strategies are indeed openly borrowed, and so aren’t neware indeed openly borrowed, and so aren’t new
What is new is the organizing model, and What is new is the organizing model, and especially the close link with theory & philosophyespecially the close link with theory & philosophy
Our response: Point this out when challengedOur response: Point this out when challenged
Experiential Exercises in TrainingExperiential Exercises in Training Are Coercive & ManipulativeAre Coercive & Manipulative
Experiential exercises used to highlight Experiential exercises used to highlight consciously self-reflective nature of ACTconsciously self-reflective nature of ACT
But must remember audience, and be very But must remember audience, and be very careful to avoid coercion, even implicitlycareful to avoid coercion, even implicitly
Degree of focus on experiential exercises Degree of focus on experiential exercises remains an unresolved issueremains an unresolved issue
Our response: Examine this issue openly Our response: Examine this issue openly within the communitywithin the community
Self-Help BooksSelf-Help Books Legitimate debate over appropriate threshold for Legitimate debate over appropriate threshold for
direct dissemination via popular literaturedirect dissemination via popular literature One extreme: must have strongly supportive One extreme: must have strongly supportive
data, not only of general approach, but its data, not only of general approach, but its effectiveness effectiveness in the self-help formatin the self-help format and for and for the the specific problemspecific problem in question in question
Other extreme: Anything goesOther extreme: Anything goes Reasonable people can disagree about this, but it Reasonable people can disagree about this, but it
is in no way unique to ACTis in no way unique to ACT Our response: Encourage authors to be Our response: Encourage authors to be
appropriately cautious, while participating in the appropriately cautious, while participating in the broader dialoguebroader dialogue
Obscurantist JargonObscurantist Jargon
The problem is that one person’s The problem is that one person’s obscurantist jargon is another’s technical obscurantist jargon is another’s technical vocabularyvocabulary
Ironic, in that all other areas of natural Ironic, in that all other areas of natural science have technical languagesscience have technical languages
To evaluate jargon, must look at things like To evaluate jargon, must look at things like theoretical coherence, precision, scope, and theoretical coherence, precision, scope, and connectivityconnectivity
Our response: Develop the language as Our response: Develop the language as necessary, but be mindful of Occam’s razor. necessary, but be mindful of Occam’s razor. Distinguish scientific talk from clinical talk Distinguish scientific talk from clinical talk
Bottom Line: Criticisms Fall into Bottom Line: Criticisms Fall into Four CampsFour Camps
Those based on ignoranceThose based on ignorance Those based on styleThose based on style Those in reaction to a challenge to the Those in reaction to a challenge to the
status quostatus quo Those that address substantive issuesThose that address substantive issues
Critical to distinguish these, as each calls Critical to distinguish these, as each calls for different responsesfor different responses
Criticisms Based on IgnoranceCriticisms Based on Ignorance
Educate (e.g., journals, workshops, Educate (e.g., journals, workshops, books, presentations), with a books, presentations), with a sensitivity to the audiencesensitivity to the audience
Criticisms Based on StyleCriticisms Based on Style
Attempt to understand the reaction, Attempt to understand the reaction, and decide how to respond. We are and decide how to respond. We are not obligated to address every not obligated to address every stylistic criticism. But we should be stylistic criticism. But we should be mindful of our audience and our mindful of our audience and our purposepurpose
Criticisms Based on Challenges Criticisms Based on Challenges to the Status Quo:to the Status Quo:
Continue to do good science, Continue to do good science, including modifying theories and including modifying theories and technologies based on datatechnologies based on data
Science is inherently self-correcting, Science is inherently self-correcting, so if ACT lives up to its promise it will so if ACT lives up to its promise it will eventually win hearts and mindseventually win hearts and minds
But be wary of striking the pose of But be wary of striking the pose of Galileo; it isn’t enough to be novel – Galileo; it isn’t enough to be novel – we must also be “right”we must also be “right”
Substantive CriticismsSubstantive Criticisms
Carefully consider substantive Carefully consider substantive criticisms, especially those criticisms, especially those challenging the evidential warrant of challenging the evidential warrant of specific claims and specific specific claims and specific theoretical issuestheoretical issues
Then, offer a thoughtful response, Then, offer a thoughtful response, and remain open to change when and remain open to change when appropriate based on arguments and appropriate based on arguments and datadata