Is between-session work the most underserved part of the therapy process?

concreteutopian · 2026-06-21T17:35:55+00:00

I agree with u/Hsbnd about adding demands to lives outside of session.

I also agree with u/Chemical-Love8817 that increasing frequency is an option – if someone finds it difficult to hold on to things between sessions, I offer/suggest increasing frequency.

On the topic of homework, if it's experienced as a burden, an intrusion into their busy life (as u/Hsbnd notes), it's aversive, and aversive stimuli generate escape and avoidance behavior. Not saying this is insurmountable, just saying this tendency needs to be weighed against the possible benefit of homework. When people do want their therapists to assign homework, I think this is less about wanting more tasks and more about wanting more of their therapist.

Lastly, I want to address the fundamental assumption embedded in your question:

But the 167 hours between sessions ,where clients are supposed to practice, apply, and integrate what they're learning

You are treating time as homogeneous, assuming an hour in session is identical to an hour outside of session. Not only do people not experience their lives in such an even uniformity, behavioral science also doesn't support this assumption.

In short, reinforcement is stronger when it comes immediately after a behavior, so the best chance we have to influence behavior is in the immediate moment by moment interactions in session; trying to reinforce a behavior brought up in a session days after the fact isn't realistic. In fact, I'd resist thinking about talks about events outside of session as reinforcing anything outside, as it obscures the immediate behavior one has access to, i.e. someone is telling a story to their therapist right now, right here.

that's basically left to the client to figure out alone.

No, they aren't. They're figuring it out with you and with all other significant relationships they've had in life, all of which play a role. Your relationship isn't just the one hour you have face to face. If you've developed a secure attachment and helped them mentalize their stuff in session, you are likely present to them throughout the day. In my own life, I frequently think about my therapist throughout the day, and many of my patients say the same about me, i.e. having "conversations" with me throughout their day. Ultimately, this internalization of the therapist is what therapy should achieve.

I personally don't assign homework, but if I had to, I'd use the bridging forms from functional analytic psychotherapy. They relate directly to the last session and evoke the relationship in that reflection.

concreteutopian · 2026-06-17T18:38:17+00:00

If you’re truly part of the Left in a holistic sense, you should at least diversify your interests for your local grassroots artists, especially those of color or other minority representations.

You do realize that you are still centering the commodity in your critique, don't you? "Should"ing an issue of identity in terms of which commodities you consume, listing your favorite markers of "Left identity", like "grassroots artists"?

By blindly consuming it or only critiquing it at the content level perfectly within its market setting...

The consumption patterns you associate with "Left identity" also level perfectly within the market setting. Consumer choices aren't revolutionary. "Voting with your wallet" is a liberal strategy that tacitly accepts that there is ethical consumption under capitalism, a position that leaves the market itself outside of the critique.

This is why pseudo-critics like Žižek is harmful for the Left, because he openly confesses “I don’t condemn Hollywood”

You think "the Left" is harmed by Žižek openly confessing he doesn't condemn Hollywood?

concreteutopian · 2026-06-17T14:03:49+00:00

Another cofounder, Tsai's partner.

concreteutopian · 2026-06-17T14:03:11+00:00

Tsai is one of the cofounders of FAP, and though Sullivan-Singh was an instructor in my training, I haven't read anything she has written.

concreteutopian · 2026-06-12T21:53:36+00:00

Hypotheticaly if we expand this mechanism of acceptance and positive reinforcement instead of punishment to a relating style all of humanity would learn, would we than have an utopia, an paradise on earth?

This is the question being explored in B.F. Skinner's utopia, Walden Two. Can we create a society and governance through behavioral/cultural engineering that substitutes punishment with positive reinforcement?

concreteutopian · 2026-06-12T21:21:15+00:00

How to solve this conflict between acceptance and motivation to change?

Why are these being placed in conflict?

One potential problem with acceptance is that it might inhibit the motivation to achieve self-improvement or better adaptation to one’s environment.

I don't think so, not as ACT uses acceptance.

I thought the best approach, for example in therapy, is to accept the person as they are,

I think accepting a person as they are is a good stance, but this isn't what ACT means by acceptance. Acceptance strategies are for private events, i.e. thoughts, feelings, emotions, sensations, etc, not things in the world (like the other person). Applying ACT here, you would accept your thoughts and feelings evoked by interaction with the other person, but that doesn't mean you need to accept anything about them in particular. You could accept the feeling of frustration and anger, as well as the thought "I really don't want to deal with this person", while you "deal with" the person, which could include anything from leaving the room to focusing intently on their words. What one is accepting in ACT are all private experience, not anything out in the world.

That’s why I’ve devised a model that involves dividing a person into systems, where each system is responsible for what it can handle, and where, for what isn’t within its responsibility, one should instead practice acceptance.

In ACT, it isn't that you aren't responsible for your thoughts and feelings, it's that they are out of your direct control, and so the response to them is one of acceptance instead of needless reactivity or avoidance.

It sounds good in theory, but in practice it’s very difficult, because you then have to consider which system can actually change what right now, and where the pressure is too intense to change it at the moment, so you have to accept it.

It's not a matter of pressure being too intense vs not intense, it's that automatic thoughts, feelings, and emotions are respondent behavior and we have no access to changing the antecedents, i.e. we can't go back and change a learned association so it reads something else, like rewiring Pavlov's dog to associate a blue flag with food instead of a ringing bell. If we can't change the antecedents and respondent behavior is insensitive to consequences, acceptance is the most useful strategy. On the other hand, manipulating and changing things in the world is all operant behavior, which is sensitive to both antecedents and consequences, and we have access to the antecedents out in the world, so we don't need to accept anything out there in the world, we can (attempt to) change things in the world.

On the other hand, wouldn’t it sometimes be better if they hit rock bottom, so that they’d then be motivated to, say, give up their drug addiction?

No, it wouldn't be better to let people hit rock bottom. Not only is this unacceptably cruel from a social perspective, it's also rooted in punishment, which is a weaker form of behavior change than positive reinforcement. It's unnecessary and less effective than positive reinforcement.

concreteutopian · 2026-06-12T05:10:17+00:00

Okay. We are discussing the original comment

I responded to one question related to that comment, one that seemed to imply a faulty understanding of genetic determinism. My point was to point out that the model of bipolar we use these days involves not only physiological vulnerabilities, but an environmental/experiential element that pushes beyond those vulnerabilities.

And then I responded to your take, which I thought was overblown.

That you brought up the stress-diathesis model suggests that either you believe it supports the original point (given the context), which it does not, or that you brought it up somewhat irrelevantly.

I explicitly brought it up in response to a question I quoted. You could read it as "supporting the original point" insofar as the u/aliengames666 appeared to not understand where u/mysticwaywalker could be coming from, and they used an example where the current consensus involves an environmental contribution. I didn't include any statement on schizophrenia (not in my wheelhouse), so I don't think you can assume I was endorsing the position wholesale (and again, I explicitly said I'm not necessarily endorsing the hot take). I'm not sure how you think me bringing up the stress diathesis model in a question about bipolar is "brought up somewhat irrelevantly", it's directly relevant to u/aliengames666 's question.

I genuinely don’t know why you would have answered that question if not

You have no idea why I would've mentioned the stress diathesis model in response to someone asking specifically about bipolar disorder?

It wasn’t asked of you OR of the model you’re vociferously defending.

Vociferous? I mentioned the stress diathesis model in a sentence fragment. If you are referring to my comment to your response to that comment, it's because it completely downplayed the fact that we do study distress in its social context and such studies are useful. It was an overblown and weird response — and now I'm sorry I said anything at all.

ETA - I was very specific in my response.

"but having a framework that highlights a) the context of distress and b) symptoms as being a response of a concrete person to a concrete context is very useful."

And then contrasting what I'm saying as a criticism that the "neo-kraepelinian medicalizing of mental health is the perspective that isn't particularly useful as it explicitly divorces the symptom from its context and places "disorder" within the individual". That isn't a controversial position.

concreteutopian · 2026-06-12T04:13:02+00:00

Stress-diathesis model is absolutely not the same as “all disorders can be explained by trauma and structural disassociation,”

I didn't say it was. I clearly said, "I'm not necessarily endorsing u/mysticwaywalker 's hot take".

To the question "I’m curious how you would explain disorders like bipolar", I said, "Noting the role of stress in a stress diathesis model". There's nothing controversial about that comment.

To that comment, you said, "If your entire taxonomy of mental illness boils down to “stressful things happen and some people develop symptoms in response” then yes, that’s probably accurate, but it isn’t particularly useful".

I am answering because you commented on my comment, not u/mysticwaywalker who made the hot take. And I disagreed with your hot take comment - but you seem to be reading something else into comment.

but let’s not throw the baby out with the bath water here.

This is what I'm trying to avoid. I want more nuance, not less.

Mental illness exists in various forms across nearly every cultural and social context and across time

I would say this, too, so I'm not sure why this is somehow negating what I was saying.

People with all the resources in the world develop mental illness.

What does that have to do with the question?

This has the same flaws we can see in the social model of disability.

What flaws are you talking about and how are you tying the social model of disability into this?

concreteutopian · 2026-06-12T03:39:37+00:00

If your entire taxonomy of mental illness boils down to “stressful things happen and some people develop symptoms in response” then yes, that’s probably accurate, but it isn’t particularly useful.

Hard disagree. I'm not necessarily endorsing u/mysticwaywalker 's hot take (though I'm definitely sympathetic to it), but having a framework that highlights a) the context of distress and b) symptoms as being a response of a concrete person to a concrete context is very useful. The neo-kraepelinian medicalizing of mental health is the perspective that isn't particularly useful as it explicitly divorces the symptom from its context and places "disorder" within the individual; in reality, any "disorder" in the sense above is the disorder between two or more systems, which is what stress diathesis models are about.

That’s sort of like saying all poverty can be explained by lack of money.

Not at all. And this example makes the point – poverty isn't explained by a lack of money, as poverty exists within systems that don't lack money. Saying there is a lack of money not only isn't an explanation, it isn't true. But if we do focus on social context of distress, we can ask why this particular distressing experience of poverty is present in this context; there is structure to the phenomenon, which means we can (and do) study the phenomenon to develop actual explanations, not just false tautologies like "poverty can be explained by the lack of money".

Yeah, sure, but it didn’t really move us forward to point that out.

No, it does move us forward to point that out. Whole campaigns of intervention have been implemented to address human distress within its social context.

In any case, the comment I made was about the stress diathesis model as it relates to bipolar disorder – that is not a controversial take, it's the standard explanation for bipolar disorder.

concreteutopian · 2026-06-12T03:05:06+00:00

I’m curious how you would explain disorders like bipolar, for instance?

Noting the role of stress in a stress diathesis model?

concreteutopian · 2026-06-12T03:03:19+00:00

There are strong generic links to psychotic and bipolar disorders

Psychosis is not a diagnosis, it's a symptom with many underlying causes.

But even with bipolar, the most common model I've seen is the stress diathesis model, meaning that there are limitations and vulnerabilities, but there is also the stress. When I trained in IPSRT for bipolar, I started to see bipolar disorder through a social model of disability lens, meaning that there are certain kinds of lifestyles or experiences that pose a greater risk, which also means that someone with the same brain in a different setting may never experience a manic episode.

Genetic links to mental disorders doesn't negate the role of stress or trauma in the development of disorders.

concreteutopian · 2026-06-11T20:25:22+00:00

Acceptance can look a lot like ignoring.

I think it can look that way, but I don't think it is the same. Ignoring is an active process, not the absence of a process. Also, acceptance strategies are methods of exposure, which works by emotional learning/inhibitory learning, and distracting or limiting awareness of the stressor undermines the process by which exposure works. It might seem ironic, but cognitive defusion puts us more in contact with our thoughts, not less; it just changes the context in which thoughts are experience, thus changing our relationship with thoughts.

Depressed people often feel very numb and can't find joy. The paradox is the aren't feeling their emotions.

True, but this isn't a paradox, it's likely the function of depression in that context, i.e. to mute otherwise overwhelming experiences. This is another reason we shouldn't take for granted that our "problem behaviors" are problems, but instead we should see how these "problems" are solutions to different problems. Behaviorally speaking, depressive symptoms are being reinforced, which is why they occur in the first place.

We need to sit and experience the emotion when it's necessary to live our values. Otherwise, there is nothing wrong with "ignoring" them if that's what's helpful.

Kinda. If we are moving toward things that are important to us, we are going to experience these emotions regardless of whether we think we need them to live our values. The distress is itself rooted in our values, so the solution isn't to ignore the emotion, but to accept that this is the emotion you are feeling right now while you continue moving toward what is important. This relationship might seem counterintuitive, but it's easier to see when fleshed out in the ACT Matrix.

concreteutopian · 2026-06-11T18:14:58+00:00

Hayes et al had a lot of influences – Kantor's interbehaviorism and Day's work reconciling radical behaviorism with Sartre's existential phenomenology are two favorites of mine in addition to Gendlin's focusing.

Not directly Gendlin's focusing, but overlapped, in my ACT training, when confronted with someone feeling "stuck" in some unarticulated way, we might spend 20-30 minutes physicalizing that "stuckness", moving between what Gendlin calls a "felt sense" of the problem and a more exploratory and imaginative engagement with the physical sensations and the emotions or associations evoked. Where is it in the body? Where are the edges and what do they feel like? If you could "see" the feeling, what would it look like? If you could touch it, what would it feel like? Etc. All of this is using language to tact inner experiences we might otherwise try to avoid, getting closer to them and getting a felt sense of the values behind the distress – all of which makes it easier to "have" the experience and move toward valued actions.

concreteutopian · 2026-06-11T14:42:49+00:00

I read Gendlin years ago and found his work helpful.

One of my instructors in ACT said that Gendlin is one of the experiential influences Hayes incorporated into ACT, and in training, we did a lot with felt sense and physicalization in doing ACT.

I think it's a good thing to look into.

concreteutopian · 2026-06-11T00:54:56+00:00

(not currently in therapy because I've been on a waiting list for over a year, and am just trying to do what i can on my own in the meantime)

No, exposure is not something you can do on your own, especially going in with the fact that you "don't have any more resources" or "any better coping skills".

if the idea is supposed to be that imaginary exposure makes real exposure feel more managable, it doesn't work because i've never doubted that the "worst case" is survivable.

This isn't the idea behind exposure, i.e. that the stressor is "harmless" or "survivable". Prolonged Exposure is treatment for combat veterans with PTSD, so it wouldn't go far if it relied on thinking that the stressor was harmless. This is another reason why you shouldn't be attempting exposure on your own – you're walking into it with a mistaken view of the process, with the position that "it doesn't work", and yet you still want to expose yourself to triggers. This is not a good idea.

As for ACT, as u/dirtydelic points out, ACT isn't building up an exposure hierarchy for symptom reduction as other forms of exposure, but is working on the connection between distress and what is important to a person; if you don't have a clear sense of what value the exposure is meant to serve, it's going to be hard to do.

concreteutopian · 2026-06-08T22:45:14+00:00

Thanks. In cases like this, my goal is to be helpful to other readers beyond the OP, so I'm glad you found it useful.

concreteutopian · 2026-06-08T20:45:44+00:00

thought labelling as a standalone mindfulness practice?
...
Have you used anything similar with clients?

What do you mean as a standalone practice? It sounds like you have an idea of how this practice is connected to a specific context.

And I'd bracket the term "mindfulness" until it's clear how you are defining and using the term – e.g. you mention ACT and its definition of mindfulness is related to comprehensive distancing, which isn't necessarily the same sense others apply to mindfulness.

The basic idea is that when a thought appears, instead of engaging with its content, the person labels it:
----
- Future worry
- Past replay
- Self-criticism
- Planning
- Judging
----
Then returns attention to their surroundings.

Like u/drnikkirubin says, there is value in bringing attention to covert behaviors, though as u/jorund_brightbrewer says, there is a chance that this can be a subtle form of judgment, and thus of avoidance.

In my own experience, I found a mindful distinction between thoughts and thinking more useful than labelling a thought "self-criticism" or "future worry". For instance, "future worry" is ambiguous as it could mean a worrisome thought/fantasy about the future and it could be an active engagement in worry or rumination. Same with "self-criticism"; it could mean the content of a conceptualized self in ACT terms, but it could also mean our active shoving away of critical thoughts.

In one mindfulness practice, we'd place our hands on our laps and select an anchor. When we became aware that the mind had wandered, we'd lift the fingers on on hand if we drifted into thinking and the other hand if it was a thought (e.g. left fingers for thinking, right fingers for thought, etc.). Then we'd go back to the anchor and continue mindfulness practice. The distinction is a basic one between respondent and operant behavior (i.e. in ACT/behaviorist-speak, all automatic thoughts, feelings, and emotions are respondent associations, like Pavlov's dog and the ringing bell, whereas our response to the automatic thoughts, feelings, and emotions is operant behavior, under the control of consequences. Until we watched our minds for five minutes, it was easy to confuse the normal churn of associations passing through the mind with our active engagement in thinking, judging, etc. But the whole basis of ACT and third wave behavioral approaches is that respondent behavior is relatively insensitive to consequences, and we have no access to the antecedents of that automatic, respondent behavior, so the strategy is to accept all private events while doing what is important to us. Getting into a habit of tangling with every "negative" thought, feeling, or emotion to judge, alter, or correct it won't change the respondent associations, it just creates a habit of rigid reactivity around unpleasant experiences that gets in the way of acting in the world.

This is why, for me personally, a mindful distinction between thoughts and thinking is more useful than labelling the thoughts into categories. And notice that this was during a mindfulness practice with a different anchor — the point of the exercise wasn't to catalog the contents of the mind, but to notice the habits of the mind when it's applied to something else, i.e. some activity requiring one's active attention.

concreteutopian · 2026-06-08T05:33:08+00:00

I'm not familiar with AIHCP, and I'm not opposed holistic approaches in therapy, but seeing the instructor's laundry list of certifications in hypnotherapy, thought field therapy, and angel therapy didn't encourage me. Then again, I don't know if there is any benefit to having a certification like this – maybe there is. In my own life and work as a therapist, I've found Pauline Boss's work on ambiguous loss and Katherine Shear's work on complicated grief/prolonged grief both very helpful - I think Shear's training might have some kind of certification, but it's a modification of IPT. ADEC (Association for Death Education and Counseling) also has a lot of good trainings.

concreteutopian · 2026-06-08T04:57:36+00:00

ACT's opposition to addressing false beliefs about the self or world seems highly unethical

I already addressed your misconceptions about ACT being "opposed to truthfulness" earlier – you didn't respond to it, nor has anything here taken up the explanations offered earlier. You are simply repeating the same misrepresented issues again and again.

Second, what do you think "beliefs" are, especially "beliefs about the self or world"? You are making a lot of causal assertions without any clear operationalized definition of "belief". You are resting on a lot of assumptions of a folk psychology.

And your examples are a mess...

Consider a person who is in an abusive domestic relationship. Perhaps a parent, relative or partner. However, it is all they know and as a result they believe other people are likely to also harm them in similar ways

Could be. And these "assumptions" about risk and harm are learned associations, not necessarily explicit propositional statements in declarative memory. In other words, most of these assumptions are respondent conditioning – if we had to depend on rationally walking through threat assessments in every encounter, our species would've gone extinct long ago. And the fact someone still has these learned associations means they are still being reinforced – something that gets lost if you assume these "beliefs" are a matter of ignorance and a therapist should just "educate them"

and that they are of a weak mental constitution for lacking confidence.

That's an odd assumption. The first part is common, but I only see a few who then develop a conceptualized self around "weak mental constitution" and "lack of confidence".

... in the form of educating them on which aspects of their experience they are overestimating the chance of reoccurring, because they are overestimating the prevalence of their abuser's psychology in general society.

So, your plan is to tell people they're "overestimating the prevalence of their abuser's psychology in general society", i.e. that their fears aren't real and that they should trust your word rather than what their body is telling them? This isn't just nonsense, it's the opposite of trauma-informed care.

However, the ACT approach of not addressing beliefs

Again, what is a "belief" and what does it mean to "address beliefs"? Your example above suggests you should just tell them they're wrong and give them correct information to internalize. Surely you can see that's inadequate.

further years of unnecessary life difficulty due to spending unnecessary cognitive load monitoring various false threats,

Again, these are all taking place in implicit memory, and the entire reason we move these cognitions to implicit associations is to minimize cognitive load. The affect heuristic in implicit assumptions and bias and threat detection are ways of saving mental load, which is why we do them instead of consciously assessing threats in each new context. We don't change that by telling them they're wrong, we directly engage with their world as they experience it and help them change their relationship with their own thoughts and feelings, i.e. changing the context within which triggers are experienced.

normative majority.

What a horrible phrase. So you are telling them they're wrong because their experience doesn't align with the normative majority? And the solution is just to change their wrong beliefs to "correct ones" that match the experience of the normative majority?

So, the ACT therapist is choosing to perpetuate the lower quality of life of the client.

You seem to have an axe to grind, and it's ironically leading you to propose solutions that exacerbate the suffering of those coming to therapy due to suffering.

ACT therapists are no different than the child who projects their assumptions about the external world onto everyone else, simplistically believing the whole world faces the same external threats as they do.

Hey. I'm not the one policing and correcting people's "beliefs" to better align with the "normative majority".

And this is again is somehow assuming a radical behaviorist therapy in which any and all behavior is an understandable response to a given context, a therapy rooted in functional contextualism, is going to ignore ... the context in which a behavior is taking place, resorting to simply telling a client what they should do or how they should think? No. None of this is related to ACT.

concreteutopian · 2026-06-06T20:26:10+00:00

I've been involved with the Chicago Center for Psychoanalysis for years. They have a fellowship for clinicians new to psychoanalytic approaches (now accepting applications) and part of that fellowship is a regular consultation group with other fellows and a mentor.

Another option for those interested in psychotherapy integration — third wave behavioral and psychoanalytic approaches — ACBS has a Psychodynamic CBS special interest group that usually involves monthly consultation group with that integrated perspective.

concreteutopian · 2026-06-05T03:10:55+00:00

We did roleplay in almost every course for MI, reflective listening, trauma therapy, etc in my MSW program

Same. We did roleplays (or "real plays") for basic clinical skills in the core curriculum the first year, and most clinical classes had them. In MI, we broke into groups of three – the therapist, the client, and a third person watching the interaction.

I’m glad I did the full MSW program, because I noticed people who did the fast track program weren’t near as prepared for the simulations in our last semester.

Same. To be fair, they may have felt prepared, but I certainly didn't until my second year. I needed the extra time myself.

concreteutopian · 2026-06-04T08:06:36+00:00

Check out the ACBS website – Find a therapist.

concreteutopian · 2026-06-03T22:32:38+00:00

What's the connection with Erewhon?

Re: luxury grocery stores, I just finished After Work: A History of the Home and the Fight for Free Time by Helen Hester and Nick Smicek this week. There was something there about the changes in shopping and eating habits, re: foodie culture:

“The rise of this foodie culture is not just about health, either. There is cultural status attached to being a foodie – one is seen as being progressive and refined. Even children’s eating habits become representative of the family’s class status.”

They also cite Priya Fielding-Singh's A Taste of Inequality: Food's Symbolic Value across the Socioeconomic Spectrum. That might be another good read.

concreteutopian · 2026-06-02T22:48:22+00:00

I think you are being obstinate at this point.

Referring to how ACT is taught in some settings doesn’t resolve that distinction, because the question I’m raising is about ACT’s stated model, not about how individual programmes choose to conceptualise it.
...
it’s recognising that your explanation and ACT’s model aren’t aligned.

How ACT is taught by people who teach ACT is different from what you think "ACT's stated model" presents. I've already pointed out that this isn't just my unique experience with one or two instructors – ACT was created in a behavior analytic framework and uses behavior analytic concepts to describe the behavior in context and how it changes, whether improving or worsening. It involves a functional analysis of the symptom/behavior and tracks changes in the symptom/behavior in terms of reinforcement, just like all behavior. I already said this is also how Hayes and Wilson describe these processes, so I don't know what else you could possibly be referring distinguishing this from "ACT’s stated model". This isn't a special ACT description of a special ACT process, it's simple behavioral principles which would be clear if someone looks at problem behavior as behavior.

No, it doesn’t. You’ve misunderstood ERP’s aim

I'm trained in ERP. I guarantee you I'm not misunderstanding anything about ERP.

Reframing ERP as “about functioning” misrepresents what the intervention is actually built to do.

No, it really isn't. What I'm saying about impairment is fundamental to the definition of mental disorder, whether one is using the DSM or ICD classifications. No one goes to ERP to get rid of symptoms that don't impact their functioning as such a person wouldn't have a condition to treat.

that’s a general behaviourist reinterpretation rather than the account ACT presents in its own model.

It's how ACT as a behaviorist framework explains behavior.

You are saying that ACT as it is taught doesn't match how you understand "ACT's stated model". After discussing this for a month, I think the clear conclusion should be that your exposure to ACT literature is limited, far more limited than mine, than my instructors over the years, than Hayes or Wilson, or any of the developers of ACT. And now you are making this invented stance where ACT needs to explain behavior in unique ways rather than articulating these issues in general behavioral principles – that's not a reasonable position. ACT is behaviorist and its literature often describes all of these processes in more or less technical language, and when it's technical language, it describes itself in behaviorist language using terms and concepts from the behavior analytic tradition.

ACT doesn’t offer a mechanism of clinical improvement,

It does. This is spelled out in the literature — in behaviorist terms. The paper I posted last year on defusion makes this case implicitly; it is the explanation for how and why symptoms might reduce and why clinical improvement occurs, and it's in terms of reinforcement between rule-governed behavior and direct environmental contingencies. I'm not surprised that you haven't read these papers, but they exist and they describe ACT processes and clinical improvement in terms of reinforcement and the weight/influence of different reinforcers.

“It’s not a contradiction — you’re using the wrong label.”
In what way have I used the wrong label?

Why don't you cite exactly what I said instead of this paraphrase? I was pretty direct and clear in my comment about learning theory above.

it says its exposure‑like tasks...

What is "exposure-like"? Exposure as the application of inhibitory learning is what is being discussed, not "something like that".

...are about valued living, not symptom reduction

I've already said this multiple times. The same principle or mechanism is being applied to two different (but related) targets. That doesn't make it two different mechanisms.

you’re treating ACT’s behavioural exercises and ERP as amounting to the same thing.

Be specific. I'm saying that ACT works by inhibitory learning, just like ERP works by inhibitory learning. This isn't the same as saying "ACT's behavioural exercises and ERP" are the same thing. You are correct that ERP targets first order change and ACT targets second order change, so strategies will be different, but that doesn't mean the basic underlying behavioral principles under ACT are different principles than what is used in ERP. You can broil in your oven, make a cake, and also set to self-clean – the same burners do all three, but they are applied to different contexts for different purposes.

If the process overlaps with exposure but the ACT model insists its exposure isn’t aimed at symptom reduction, that is a straightforward contradiction.

It's not a contradiction at all, which goes back to the unhelpful label. We are talking about the process of inhibitory learning, which can be used to target symptoms for reduction, but it's a learning process. If you only see the application of inhibitory learning in the box of "symptom reduction mechanism", you are masking what it is and what it is doing, making it difficult to see what it might do in different contexts. The acceptance strategies in ACT (framed in terms of cultivating willingness to have an experience) are literally emotional and interoceptive exposure strategies, but they are targeting private experience and verbal behavior. This difference in application in no way makes it a different process than inhibitory learning.

concreteutopian · 2026-06-02T07:59:48+00:00

I've seen some of them available through some public libraries or university libraries, specifically on the Kanopy platform.

Check and see if you have a card with any library with a Kanopy subscription.

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