Cognitive Defusion in Acceptance and Commitment Therapy: What Are the Basic Processes of Change?

Abstract

Acceptance and commitment therapy (ACT) is a contextual-behavioral approach to psychotherapy and other behavioral health concerns that has progressively attracted attention from both researchers and clinicians. ACT's psychological flexibility model relies on middle-level terms that, despite being less precise than behavioral principles, are seen as being valuable for teaching and practicing ACT. One such term is cognitive defusion, which refers to the reduction of stimulus function transformation that occurs through verbal relations. In other words, defusion aims to minimize the influence of verbal relations, such as thoughts, on behavior, when doing so leads to adaptive behavior and valued living. Recently, some authors have stressed the importance of functionally defining middle-level terms, establishing clear links between the concept and basic behavioral processes. This article begins this endeavor by analyzing these links with respect to cognitive defusion. First, we briefly contextualize ACT's theoretical roots. Second, we present cognitive defusion as a therapeutic intervention, reviewing its objectives, procedures, outcomes, and hypothesized processes as stated in the relevant literature. Third, the outlined process of change is critically examined, leading to a new conceptualization of cognitive defusion. Finally, the conceptual, clinical, and research implications of this new conceptualization are considered.Keywords acceptance and commitment therapy . cognitive defusion . process of change . middle-level terms . relational frame theory * Daniel A.

Laboratory analogue investigation of defusion and reappraisal strategies in the context of symbolically generalized avoidance

“…The underlying assumption of these strategies is that cognitive appraisals of stimuli (perceived verbal meaning) cause behavior (avoidance). In terms of procedure, reappraisal may involve establishing new networks of relational responding that are incompatible with target relations (e.g., relation of coordination between aversive and neutral stimuli) and reduce the probability of the target relational responses (Assaz et al, 2018;Blackledge, Moran, & Ellis, 2009). More specifically, according to Gross' (2002) emotion processing model, cognitive reappraisal is the technique of thinking differently about emotion-eliciting stimuli in order to alter their verbal meaning which would result in a changed emotional and behavioral reaction.…”

“…Rapid vocal repetition is the most studied cognitive defusion technique (Masuda, Hayes, Sackett, & Twohig, 2004;Masuda, Hayes, & Twohig, 2009;Masuda et al, 2010). Some researchers conceptualize the procedure as a violation of language parameters (replacement of contextual cues; Blackledge, 2007), while other researchers believe the procedure is synonymous with exposure (Assaz et al, 2018). The derived functions (i.e., psychological functions of imagining milk, such as a cold temperature, white color and creamy texture) are disrupted in favor of direct functions (i.e., experience of the word's component phonemes) (Blackledge, 2007).…”

“…When translating cognitive constructs into behavioral principles a distinction has been made between cognitive constructs as procedures, processes, and outcomes (Assaz, Roche, Kanter, & Oshiro, 2018;Barnes-Holmes, Hussey, McEnteggart, Barnes-Holmes, & Foody, 2016). Assaz et al (2018) defined "a procedure as the manipulation of environmental events, a process as the changes in the interaction between the organism and its environment, and an outcome as the change in the organism's dispositional state or behavioral tendency" (p.227).…”

“…When translating cognitive constructs into behavioral principles a distinction has been made between cognitive constructs as procedures, processes, and outcomes (Assaz, Roche, Kanter, & Oshiro, 2018;Barnes-Holmes, Hussey, McEnteggart, Barnes-Holmes, & Foody, 2016). Assaz et al (2018) defined "a procedure as the manipulation of environmental events, a process as the changes in the interaction between the organism and its environment, and an outcome as the change in the organism's dispositional state or behavioral tendency" (p.227). Being verbally mediated (presented verbally by therapists), most cognitive interventions likely involve manipulations of both relational cues and functional cues, as well as other procedures (e.g., differential reinforcement of new response; Assaz et al, 2018;S.…”

“…Assaz et al (2018) defined "a procedure as the manipulation of environmental events, a process as the changes in the interaction between the organism and its environment, and an outcome as the change in the organism's dispositional state or behavioral tendency" (p.227). Being verbally mediated (presented verbally by therapists), most cognitive interventions likely involve manipulations of both relational cues and functional cues, as well as other procedures (e.g., differential reinforcement of new response; Assaz et al, 2018;S. C. Hayes, Levin, & Plumb-Vilardaga, 2013).…”