Is ACT Just a Fad? Addressing the Critics

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Is ACT Just a Fad?Addressing the Critics

• James D. Herbert, Ph.D.
• Drexel University

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Emergence of Criticism

• As ACT has moved into the mainstream, a variety
  of criticisms have emerged from within the
  academic community
• As ACT becomes more popular, we can anticipate
  even more criticism from even more voices
• Common theme ACT is merely the latest
  therapeutic fad to litter the mental health
  landscape

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Lets outline the criticisms so far, examine
them critically and honestly, and explore how we
as a community may respond
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Complaints about ACT

• Overly-hyped claims getting ahead of the data
• Excessive enthusiasm among those interested the
  C-word
• Grandiose visions
• Proselytizing ACT as a way of life.
• Promotes undue influence by seeking to identify
  principles and technologies that could be used to
  impact behavior without their explicit consent

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More Criticisms

• Experiential exercises in ACT training are
  coercive manipulative
• Theres nothing really new here
• Premature dissemination to the public via
  self-help books
• Both ACT and especially RFT are plagued by
  obscurantist jargon

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Lets look at each of these in turn
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Getting Ahead of the Data

• Must examine evidential warrant of specific
  claims
• Ratio of theoretical to empirical papers isnt a
  proxy. Nor are dreams/visions
• Some critics are clearly unaware of the data that
  exist those who are correctly note that its
  limited, but dont generally compare specific
  claims with evidence
• ACT proponents have in fact been appropriately
  cautious in claims
• Our response Continue to be clear about
  specific claims

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Excessive Enthusiasm

• Largely based on reactions to listserv, and to
  reactions of some professors to their students
  returning inspired from workshops
• But enthusiasm per se is only a problem if it
  interferes with critical thinking. Any evidence
  of this?
• Our response Make sure not to be blinded by
  enthusiasm

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The C word Is ACT a Cult?

• Cult label usually evoked by
• A closed system
• a charismatic leader
• a strong profit motive
• financial and/or sexual exploitation of
  vulnerable populations
• a hierarchy of secretive levels to pass through
  in order to gain special knowledge or status
• intolerance of dissent
• Such groups also
• challenge the status quo
• offer a grand vision
• engender high levels of enthusiasm

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Is ACT a Cult?

• The first set of features dont apply, but the
  second set clearly do
• However, these latter features are poor
  discriminators of science vs. pseudoscience or
  cults
• Our response This is silly ignore it

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Grandiose Visions

• Rightly or wrongly, ACT does indeed aspire to
  great things
• Helps to understand history of behavioral
  analysis to appreciate the historical context
• Critical to distinguish specific claims from
  distal goals/dreams the former are subject to
  direct examination via evidential warrant the
  latter are not
• Compare biotechnology conference last month in
  Philadelphia
• Problem is that mainstream psycho-therapies are
  cautious about big claims, whereas many dubious
  ones are not
• Our response Clarify explicitly the distinction
  between specific claims and distal visions

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Proselytizing ACT as a Way of Life

• Two variations Clinicians must adopt an ACT
  perspective to their own life, the focus of the
  clients presenting problem is inappropriately
  shifted to ACT-consistent goals
• Although ACT does suggest that clinicians try out
  some principles on themselves, it doesnt require
  them to adopt any particular belief system
• Re. clients, again this is not unique to ACT, as
  all psychotherapies attempt to socialize the
  client to their model. The key in all cases is
  informed consent
• Our response We could probably be clearer on
  these points

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ACT Seeks Undue Influence

• Familiar criticism to radical behaviorists
• Ethics surrounding parameters of informed consent
  is an important cultural value, and like all
  values, must be decided independent of science
  per se
• Extreme Libertarian stance rules out all public
  health interventions (e.g., programs promoting
  smoking cessation, safe sex to prevent STDs,
  routine diagnostic procedures like mammograms and
  prostate exams, childhood vaccinations)
• The fact that a technology could possibly be
  misused is no reason to stifle science
• Our response Participate in the broader public
  ethical dialogue

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ACT Offers Nothing New

• Generally argued by those with minimal
  familiarity with ACT. Ironically, CBT folks who
  make this argument have themselves been on the
  receiving end of this allegation from
  psychoanalysts others
• Many (though not all) techniques and strategies
  are indeed openly borrowed, and so arent new
• What is new is the organizing model, and
  especially the close link with theory
  philosophy
• Our response Point this out when challenged

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Experiential Exercises in Training Are Coercive
Manipulative

• Experiential exercises used to highlight
  consciously self-reflective nature of ACT
• But must remember audience, and be very careful
  to avoid coercion, even implicitly
• Degree of focus on experiential exercises remains
  an unresolved issue
• Our response Examine this issue openly within
  the community

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Self-Help Books

• Legitimate debate over appropriate threshold for
  direct dissemination via popular literature
• One extreme must have strongly supportive data,
  not only of general approach, but its
  effectiveness in the self-help format and for the
  specific problem in question
• Other extreme Anything goes
• Reasonable people can disagree about this, but it
  is in no way unique to ACT
• Our response Encourage authors to be
  appropriately cautious, while participating in
  the broader dialogue

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Obscurantist Jargon

• The problem is that one persons obscurantist
  jargon is anothers technical vocabulary
• Ironic, in that all other areas of natural
  science have technical languages
• To evaluate jargon, must look at things like
  theoretical coherence, precision, scope, and
  connectivity
• Our response Develop the language as necessary,
  but be mindful of Occams razor. Distinguish
  scientific talk from clinical talk

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Bottom Line Criticisms Fall into Four Camps

• Those based on ignorance
• Those based on style
• Those in reaction to a challenge to the status
  quo
• Those that address substantive issues
• Critical to distinguish these, as each calls for
  different responses

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Criticisms Based on Ignorance

• Educate (e.g., journals, workshops, books,
  presentations), with a sensitivity to the
  audience

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Criticisms Based on Style

• Attempt to understand the reaction, and decide
  how to respond. We are not obligated to address
  every stylistic criticism. But we should be
  mindful of our audience and our purpose

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Criticisms Based on Challenges to the Status Quo

• Continue to do good science, including modifying
  theories and technologies based on data
• Science is inherently self-correcting, so if ACT
  lives up to its promise it will eventually win
  hearts and minds
• But be wary of striking the pose of Galileo it
  isnt enough to be novel we must also be
  right

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Substantive Criticisms

• Carefully consider substantive criticisms,
  especially those challenging the evidential
  warrant of specific claims and specific
  theoretical issues
• Then, offer a thoughtful response, and remain
  open to change when appropriate based on
  arguments and data