Analysis of RFT

[u/Hatrct]

While I can see its connection to ACT, I find it interesting that some of it can also relate just as/perhaps even more strongly with, CBT.

For example, it talks about rules. For example "I need to be nice to people in order to not feel bad" But these rules really sound like core beliefs. So they can also be targeted via CBT. So yes, cognitive defusion for example can help in this regard, but I would argue only to a point, it seems like ultimately CBT style interventions such as cognitive restructuring would be necessary.

I also think that a lot of RFT principles are just common sense. They make certain common sense observations (such as the word fox = an actual fox = a picture of a fox) into a formal science with boxes and categories and arrows and fancy labels such as "combinatorial entailment".

I think they are trying to show that a lot of psychopathology results from A) classical conditioning B) operant conditioning C) relational conditioning. And they are trying to focus on C.

But again, in terms of practical clinical utility, I think they overdo it at times. I think practically/clinically, the biggest takeaway from RFT is that language can be exaggerated/general language can be used to exaggerate negative thoughts/feelings even when the language is not objectively that relevant/applicable/valid in terms of a specific context. And what follows from this in terms of clinical interventions is for example cognitive defusion. But if you think about it, cognitive defusion is just psychoeducation to the client: you are just explaining to them the pitfalls of language, you are not actually doing anything to change their distorted/incorrect use of language. I guess you can argue that this is done through the experiential exercises, but I don't think some metaphors about cognitive defusion for example are going to be sufficient in this regard. The metaphors will just help the person remember the concept faster, but it won't necessarily change their belief in their rules/core beliefs (see 2nd paragraph from the beginning of this post), or it won't change their distorted/incorrect/exaggerated use of language: to do this you need to address these errors using CBT. I would argue that incorrectly using language is also a form of cognitive distortion.

[u/SUDS_R100]

So, I think to understand RFT and what it actually offers in terms of novelty/utility here, we have to understand the historical context.

For example, it talks about rules.

The notion of rule-governed behavior dates back to well before RFT, and this, in part, highlights what RFT offers. Skinner distinguished between rule-governed behavior and contingency-shaped behavior in the late 60s, and like any behavioral-analytic term, it carried with it a proposed technical meaning. Skinner stated that rule-governed behavior was evoked by “rules derived from contingencies, in the form of injunctions or descriptions which specify occasions, responses, and consequences” (Skinner, 1969, p. 160).

This is a quite technical rabbit hole, but essentially, Hayes and colleagues identified some practical problems with this (and other) definitions of rule governed behavior, positing their own (i.e., “behavior controlled by antecedent verbal stimuli,” with some caveats added by other authors) which they saw as having more utility for the analysis of such behaviors. In fact, this is much of what RFT is doing, presenting a new conceptual framework with new definitions to terms to make them more workable in a scientific context.

I also think that a lot of RFT principles are just common sense…

To my previous point, the term combinatorial entailment is also a technical term which closely resembles a term in behavior analysis that predates it - “transitivity.” Transitivity came out of an application of mathematical set theory by Sidman and colleagues (i.e., ‘stimulus equivalence’) to analyze conditional discrimination performances. The very new part is that RFT is purporting to provide a mechanism for this type of learning/broad phenomenon rather than just a descriptive account of people picking up A = C for free. The big idea is that relational learning is a kind of higher-order, generalized operant which has implications for how we understand and analyze these more macro phenomenon like language and cognition.

To be candid, I don’t claim to be an expert in any of this, I’m probably like 30 IQ points short of fluency here, but long story short, the idea of cognitive distortions as it is used clinically is basically useless in this very technical context. On the other hand, to your broader point, in some applied contexts, the term cognitive distortion might have greater utility.

To address the rest of the post though, I think you have to be very careful about using “language” so literally when you talk about RFT/ACT. Yes, there is a focus on language (i.e., the words we use), but language as we think about it is kind of downstream from the more fundamental process that lives in the technical world I described above. To this point, Hayes and Hofmann wrote a paper on the potential role of these processes on the evolution of consciousness as we know it. It’s far more than the words themselves.

The cool thing is metaphors and experiential exercises (and plain old psycho education for that matter) can actually change core beliefs. If RFT is right, recontextualization is pretty much all any therapy is. Even teaching someone to identify cognitive distortions is creating and strengthening new relational frames (i.e., the same negative thought is being labeled with new meaning based on the shifting context of being in therapy and learning to identify negative automatic thoughts).

[u/concreteutopian → u/SUDS_R100]

So, I think to understand RFT and what it actually offers in terms of novelty/utility here, we have to understand the historical context.

Sure, while it is building on several preexisting conversations, it is also offering something new.

Hayes has said a number of times he thinks his work on RFT is of more lasting importance than his development of ACT, and I tend to agree.years ago, I was seeing similarities between RFT and sociologies of knowledge like Berger & Luckmann and Bourdieu, meaning it can help bridge the gap between sociology, social psychology, and psychotherapy - potentially, but I haven't found anyone else interested in this application.

 If RFT is right, recontextualization is pretty much all any therapy is.

Recontextualization as a means of altering conditioning through exposure, specifically. And yes, I think this is what therapy is, whether we say "insight is exposure" like Wachtel or talk about it in terms of mentalization and emotional learning.

To be candid, I don’t claim to be an expert in any of this, I’m probably like 30 IQ points short of fluency here, but long story short, the idea of cognitive distortions as it is used clinically is basically useless in this very technical context. 

Well, I'm not an expert either, but I've been reading ACT since 2004 and studying more RFT over the past six years and your point is correct - cognitive distortion isn't a useful construct when thinking functionally about automatic thoughts. Automatic thoughts are associations, i.e. respondent conditioning, like Pavlov's dog, and respondent conditioning is relatively insensitive to consequences, it can only be modified through exposure. But the association must've been useful in the first place and is still strong enough to be noticed, strong enough to be an object of treatment, so there is something still reinforcing this association. Our (arbitrarily applied) relational framing in RFT is operant conditioning, which is dependent on consequences, so if we continue framing thoughts in particular ways to the point that they form automatic associations, that means by definition the act of such framing is being reinforced, is serving a function. If our bodies are telling us there is utility in this framing, it seems unhelpful to call this perception a "cognitive distortion".

Even teaching someone to identify cognitive distortions is creating and strengthening new relational frames (i.e., the same negative thought is being labeled with new meaning based on the shifting context of being in therapy and learning to identify negative automatic thoughts).

Meh, this is still too much focus on the content of the thought and not enough on its function. What kind of relational frame is being used to identify cognitive distortions if not one that is evaluative, e.g. "better/worse", "true/false", etc. and these new "good thoughts" are mutually entailed with the old "bad thoughts". I think seeing both our avoidance and approach as being driven by the same set of values allows us to "hear" the old thought in new ways, which is changing the meaning, as you mention, through experiencing the same stimulus (i.e. the automatic thought) in a different context.

[u/SUDS_R100 → u/concreteutopian]

Thanks for the thoughtful reply! My point at the end is to say to OP that if RFT is “true,” (although maybe some ontological nitpicking to be done here for the functional contextualist crowd), even a strict Beckian CBT therapist would naturally still be playing by the same rules when changing behavior, they’re just not thinking about it in the same terms. In some ways it’s the same scale (insofar as RFT informs ACT), and in others ways, as you alluded to with the Hayes reference, RFT goes far deeper.

Have you read the good ol’ “purple book?” If so, convince me to finally work my way through the whole thing. 😅😂

[u/concreteutopian → u/SUDS_R100]

Have you read the good ol’ “purple book?” If so, convince me to finally work my way through the whole thing

No, I read sections in my grad program, but most of what I read about RFT was from Hayes early ACT introductions, Törneke's book Learning RFT, Villatte's Mastering the Clinical Conversation, conversations in ACBS threads, and articles from JCBS or ABAI. I also had a background in Skinnerian verbal behavior from functional analytic psychotherapy and Törneke's book ABCs of Human Behavior, and a lot of that literature comments on RFT as well.

[u/Hatrct → u/SUDS_R100]

I don't doubt the validity of RFT and ACT. I just think Hayes is wrong when he completely discounts cognitive therapy. For the reasons in my OP, cognitive therapy can be just as, if not more, helpful in terms of changing something like rules/core beliefs. Hayes believes cognitive therapy is useless in this regard (you already alluded to this in your other longer comment), but I disagree.

And that relates to what I was alluding to in my OP. Hayes is wonderful, but he too unfortunately appears to have a bit of tunnel vision, and paradoxically, too focused on the acronyms "RFT" and "ACT" as compared to practical utility. That is what I mean that some parts of RFT just seem like common sense yet a formal technical label is being forced on them. Now, I understand this needs to be done as a science, things need labels/terms, but where this goes too far is when the creator of the theory gets tunnel vision to the point of completely discounting cognitive therapy for example. This shows that they are so trapped by their own scientific model and terms that sometimes they fail to see anything outside it.

It kind of reminds me of Chomsky's "language acquisition device." If you think about it, this is a meaningful term. It is just a fancy term for what happens naturally, there is no proof for it. Yes toddlers learn language quickly, this is just how it is. This is common sense. It does not prove the existence of something called "language acquisition device". This is a functionally meaningless term.

Yes, there are a bunch of relational frames and associations in terms of language, but this does not mean that cognitive therapy doesn't work. To claim this would be to claim that humans are incapable of critical thinking. The existence of critical/rational thinking shows that cognitive therapy works. Someone CAN use their brain to change cognitive distortions. How this is done/what this process is labeled is just semantics. At the end of the day this is what is happening, no matter what you want to call it. That is why I say RFT saying it links only to ACT is wrong. RFT can be a model, but it doesn't mean that it is limited to ACT. Cognitive therapy can also follow it. RFT can be explaining why cognitive distortions happen, ok, but that doesn't mean that cognitive defusion/other ACT techniques are the only ones that can fix this.

Cognitive therapy can work too. Labels are not too important. By cognitive therapy I mean something like cognitive restructuring. Basically using your brain to think rationally to improve the accuracy of your thinking. Naturally, thinking requires language, and when you think of something there are a million quick verbal associations/frames, whatever you want to call them. So if you want to use RFT terms to explain this process sure, but the clinical application is where I have a problem: to limit oneself solely to ACT and techniques like cognitive defusion BECAUSE RFT is true makes no practical/logical sense to me. Again, RFT is a model with scientific terms of whats going on when humans use language, but this is not mutually exclusive to cognitive therapy. This is hard to explain simply but I hope you understood what I mean.

Let me give some examples:

https://foxylearning.com/modules/rft-s/lessons/lesson-15-implications-and-applications/topics/15-48-bidirectional-transformation-of-aversive-functions/

"When words refer to stimuli or events that are painful or aversive, those words themselves may become painful or aversive. That is, their functions will be transformed according to their relation of equivalence to the actual stimuli or events. This process is why it can be painful and aversive to think of a dead loved one, or recall childhood abuse, or reflect on your failures, or talk about your sadness. And it allows us to “carry” the pain of aversive events for a lifetime, and experience it at virtually any time or place."

Sure, RFT can explain what is happening here, but this doesn't mean that we are solely limited to ACT. Why on earth can't we use cognitive therapy/rational thinking to fix this? The fix would be simple: hey I notice I am thinking about the past as a result of something triggering that thought, let me be rational: that trigger actually has nothing to do with my actual past, it just reminded me of it, that's all. I am in the present now, and I am enjoying my time now, let me redirect my focus back on the present". Whether you want to call this cognitive defusion or cognitive restructuring doesn't matter. This is just common sense/being rational.

Or:

https://foxylearning.com/modules/rft-s/lessons/lesson-15-implications-and-applications/topics/15-56-rule-following-and-behavioral-rigidity/

"From the perspective of RFT, learning to identify and follow rules that accurately describe the consequences of behavior and lead to desired outcomes is key to psychological health and flexibility. In education, learning to do this is a key component of what we call critical thinking."

This is the same as rational thinking/cognitive restructuring. I don't see a difference. Critical thinking=rational thinking=cognitive restructuring. So to say that ACT has exclusivity in this regard and that only ACT follows from RFT, I don't see how this is true.

When someone has a core belief, telling them to use metaphors that defuse that thought will often not be sufficient: they need to learn/agree that the core belief is not true. Cognitive defusion will temporarily let them not be affected as much by that core belief, but it will keep coming back if they keep believing it. Yes, exposure can also help in terms of changing core beliefs, but it is not always practical to do it with exposure, so cognitive restructuring can be of help too.

[u/SUDS_R100 → u/Hatrct]

Hm. I actually don’t think I’ve personally seen much from Hayes that indicates he’s critical of all cognitive therapy in all contexts. I’d be curious to see if there’s something I’m not aware of. I mean, I doubt that he’d argue that it’s not a valid approach or that no one should be doing it, my perception is just that he isn’t huge on it in the context of ACT because it can be a little confusing for patients.

The big advantage of RFT over Skinner’s account of verbal behavior (which Chomsky also ridiculed lol) is that it has actually produced a more productive basic research agenda. There is decent evidence supporting RFT and the predictions it generates.

Overall though, If people are arguing cognitive restructuring is bad full stop or can’t be explained by RFT, I think I’m pretty much in total agreement with you. I think when people talk about ACT exclusively following from RFT, they might mean that in a very literal sense (i.e., ACT actually came from RFT whereas CT developed before RFT existed)? If not they’re probably just behaviorism haterzzz. They exist (as do cognitive haters). 😂

[u/concreteutopian → u/SUDS_R100]

If people are arguing cognitive restructuring is bad full stop or can’t be explained by RFT, I think I’m pretty much in total agreement with you

"Bad full stop" isn't helpful, but the second part determines the first, i.e. because one can use RFT to explain why cognitive restructuring "works", when it works, it also explains why it doesn't work in other instances and the unintended consequences that can result from it in those instances. So not "bad full stop", but not "good".

The big advantage of RFT over Skinner’s account of verbal behavior (which Chomsky also ridiculed lol) is that it has actually produced a more productive basic research agenda. There is decent evidence supporting RFT and the predictions it generates.

Yes, though we can't ignore Skinner's verbal behavior is and has been used for decades in ABA and functional analytic psychotherapy. I'm trained in RFT, but the tools I use in session definitely have roots in Skinner. And I believed the Chomsky hype and was a Skinner hater for years until I read Skinner and then read Chomsky's critique of Skinner's Verbal Behavior. It's not good, he tries to collapse Skinner's operant take into an S-R model Skinner isn't using. This is partially why Hayes was saying out of the gate in the 80s that relational frames are operants; it's to avoid the misunderstanding Chomsky popularized.

I actually don’t think I’ve personally seen much from Hayes that indicates he’s critical of all cognitive therapy in all contexts. I’d be curious to see if there’s something I’m not aware of. I mean, I doubt that he’d argue that it’s not a valid approach or that no one should be doing it, my perception is just that he isn’t huge on it in the context of ACT because it can be a little confusing for patients.

This goes back to the "explainable via RFT" point above. Be clear about what he is promoting. Can cognitive restructuring work? Yes, sometimes, but not for the reasons Beck's cognitive therapy states. So I'm that sense, yes, he is critical of cognitive therapy's theory of change (as am I), but not necessarily the use of interventions from CBT (I've used downward arrow many times, but as a prelude to exposure, not cognitive restructuring). You need to suspend basic behavioral principles to do what OP is talking about with cognitive restructuring, so I can't see someone being a behaviorist and yet not being critical of theories that violate those principles.

[u/SUDS_R100 → u/concreteutopian]

I have read Chomsky’s critique of verbal behavior (and MacCorquodale‘s reply which essentially eviscerated it), and my master’s degree is in ABA. I’m with you on all those points, they just didn’t feel relevant to my reply because OP was comparing RFT to Chomsky’s LAD, so I wanted to highlight there was empirical evidence for RFT, and in fact, the researchability was part of the reason for the paradigm shift in the first place.

I believe your point re: Hayes’ position on the theory of change is correct, OP just made it sound like he is 100% “the applied technique of cognitive restructuring bad” and in my mind, there is no way that’s true. Hayes has to know in an applied sense that some frameworks work better than others for some people. Again, he’d frame this behaviorally, but he seems like a pragmatist above all else.

I don’t think you’re necessarily doing this, but I think we have to be a little careful with letting RFTs post-hoc explanatory power stand in for its predictive utility. Yes, if an intervention does or does not work, there is always an RFT explanation that can be formulated, but unless it gives us accurate and reliable insight into how to adjust when things go wrong it’s not really that superior to Beck’s account where he might say something like, “there was no change because cognitive distortions remained unchallenged or were too rigidly held, limiting cognitive, emotional, and behavioral change.” Practically, there could be an RFT translation that says the same thing. What’s gonna matter here is what we do about it. RFT might have the edge there in the right hands, but on average, it’s probably not going to be head and shoulders better than how a well-trained CBT therapist is going to shift approaches at this stage.

[u/Hatrct → u/SUDS_R100]

Thank you for this comment. This is the reason I create these types of posts: to hear these kind deep replies. Unfortunately your type is far and few between. My OP was downvoted into oblivion: 9% upvote rate, as such it becomes censored. I don't understand why the masses on a sub like this would prefer to censor this kind of useful clinical discussion. You and one other person are the only ones who replied, everyone else downvoted OP and did not offer any comments. Sad state of affairs. I will reply to the technical part of your comment in my reply to your other comment.

[u/SUDS_R100 → u/Hatrct]

Lol, I know we’ve had our fair share of exchanges and haven’t always seen eye to eye, but this post is an example where I can kind of see where you’re coming from with your assessment re: the sub’s reception. I saw a good faith effort, so I chose to engage. Others might be more influenced by frustrations from past exchanges.

I will say there was an ACT-critical effort post here not long ago which also got downvoted pretty heavily. I think it had some clear misunderstandings, but maybe people read this stuff as more hostile than it’s intended.

Happy cake day, and I’m sorry more didn’t engage with this one!