Content uploaded by Evelyn Gould
Author content
All content in this area was uploaded by Evelyn Gould on Apr 30, 2021
Content may be subject to copyright.
Content uploaded by Francisco J Ruiz
Author content
All content in this area was uploaded by Francisco J Ruiz on Apr 29, 2021
Content may be subject to copyright.
Journal of Contextual Behavioral Science 20 (2021) 172–183
Available online 2 April 2021
2212-1447/© 2021 The Author(s). Published by Elsevier Inc. on behalf of Association for Contextual Behavioral Science. This is an open access article under the
CC BY license (http://creativecommons.org/licenses/by/4.0/).
Conceptual Articles
Report of the ACBS Task Force on the strategies and tactics of contextual
behavioral science research
☆
Steven C. Hayes
a
,
*
, Rhonda M. Merwin
b
, Louise McHugh
c
, Emily K. Sandoz
d
, Jacqueline G.
L. A-Tjak
e
, Francisco J. Ruiz
f
, Dermot Barnes-Holmes
g
, Jonathan B. Bricker
h
,
Joseph Ciarrochi
i
, Mark R. Dixon
j
, Kenneth Po-Lun Fung
k
, Andrew T. Gloster
l
,
Robyn L. Gobin
m
, Evelyn R. Gould
n
, Stefan G. Hofmann
o
, Rosco Kasujja
p
, Maria Karekla
q
,
Carmen Luciano
r
, Lance M. McCracken
s
a
Department of Psychology, University of Nevada, Reno
b
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, North Carolina
c
School of Psychology, University College Dublin, Ireland
d
University of Louisiana at Lafayette, Louisiana
e
A-Tjak Cursussen, Emmer-Compascuum, The Netherlands
f
Fundaci´
on Universitaria Konrad Lorenz, Colombia
g
School of Psychology, Ulster University, Coleraine
h
Fred Hutchinson Cancer Research Center & University of Washington, USA
i
Institute of Positive Psychology and Education Australian Catholic University, Australia
j
Department of Disability and Human Development, University of Illinois at Chicago, Illinois
k
Department of Psychiatry, University of Toronto, Canada
l
Division of Clinical Psychology and Intervention Science, University of Basel, Switzerland
m
University of Illinois at Urbana-Champaign, Illinois
n
Harvard Medical School, Massachusetts
o
Department of Psychological and Brain Sciences, Boston University, Massachusetts
p
Department of Mental Health & Community Psychology, Makerere University, Uganda
q
University of Cyprus, Cyprus
r
Department Psychology, University Almeria, Spain
s
Psychology Department, Uppsala University, Sweden
ARTICLE INFO
Keywords:
Research strategy
Research quality
Prosocial research
Idiographic research
Social justice
Processes of change
ABSTRACT
Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had
distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS
research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current
challenges. The present white paper is the result of a 2 1/2-year long process designed to foster consensus among
representative producers and consumers of CBS research about the best strategic pathway forward. The Task
Force agreed that CBS research should be multilevel, process-based, multidimensional, prosocial, and pragmatic,
and provided 33 recommendations to the CBS community arranged across these characteristics. In effect, this
report provides a detailed research agenda designed to maximize the impact of CBS as a eld. Scientists and
practitioners are encouraged to mount this ambitious agenda.
The Association for Contextual Behavioral Science (ACBS) Task
Force on the Strategies and Tactics of Contextual Behavioral Science
Research was created by the ACBS Board in Fall 2018. The Board took
this action at the recommendation of the ACBS Publications Committee,
which believed that the association, the eld, and potential authors of
the Journal of Contextual Behavioral Science (JCBS) could benet from a
☆
Approved by the Board of Directors, Association for Contextual Behavioral Science, March 22, 2020
* Corresponding author.
E-mail address: stevenchayes@gmail.com (S.C. Hayes).
Contents lists available at ScienceDirect
Journal of Contextual Behavioral Science
journal homepage: www.elsevier.com/locate/jcbs
https://doi.org/10.1016/j.jcbs.2021.03.007
Received 24 March 2021; Accepted 26 March 2021
Journal of Contextual Behavioral Science 20 (2021) 172–183
173
clear statement of the nature and needs of the Contextual Behavioral
Science (CBS) research program. After the Board decided to create the
Task Force, input was sought from the ACBS community on the charge
and the Task Force composition. Task Force members were appointed by
then ACBS President Louise Hayes, in consultation with Steven C. Hayes,
who was appointed as the chair of the Task Force. Task Force members
were selected to represent both excellence and diverse views, as dened
by backgrounds, professions, regions, and research areas.
The Task Force was given three major tasks:
•Create a white paper on a progressive research strategy for contex-
tual behavioral research.
•Create a research quality checklist for contextual behavioral
research.
•Recommend steps in the open science effort consistent with CBS
sensitivities and strategy.
The Task Force met for two days in Dublin immediately following the
ACBS World Conference in the Summer of 2019. During that meeting,
the Task Force made the strategic decision to focus rst on the overall
strategy issue in the form of a white paper, and to apply what we
developed to the issues of research standards. We agreed to consider a
progressive CBS approach to open science issues after these rst two
steps had been taken. The open science subcommittee report will follow
the present report in a separate document.
In the Dublin meeting, a ve-part organization of key features of CBS
research emerged. It was decided that contextual behavioral research
should be multi-level, multi-dimensional, process-based, prosocial, and
practical. Recommendations would be developed consistent with each
of these features. Sub-committees were created to address each proposed
feature. After a series of sub-committee meetings, a detailed outline of
the report was developed and shared with the ACBS membership in
January 2020. Input from the membership was then shared with the
Task Force. The plan at the time was to meet in person at the ACBS
World Conference in New Orleans in 2020, in order to specify details of
the report. Because of the COVID-19 pandemic, the Task Force sub-
committees met virtually to determine the content of the report and
created a draft that was shared with the entire Task Force and then the
ACBS Board. Over the next several months, drafts were circulated within
the Task Force, and a nal report was produced and submitted to the
Association. This report was approved by the ACBS Board of Directors on
March 22, 2021.
1. Preamble and purpose
Approaching behavioral science from a functional and contextual
viewpoint is as old as scientic psychology itself. Discussing and
developing these approaches under the rubric of “Contextual Behavioral
Science” (CBS) began only with the establishment of the ACBS in 2005.
The origins of the CBS approach however are evident in functionalism,
pragmatism, behaviorism, and related intellectual traditions, as the
impact of the Darwinian revolution was felt in the earliest days of psy-
chology as a discipline. In more modern times, evidence-based ap-
proaches to intervention science such as behavior therapy, applied
behavior analysis, and many parts of the cognitive behavioral tradition
have embraced functional analytic and contextual behavioral thinking.
In the basic area, wings of contextualistic thinking in animal learning,
behavior analysis, social learning, ethology, interbehaviorism, cultural
evolution, and so on have arguably been part of a contextual behavioral
science tradition for many years.
Over the last decade and a half, CBS began to take form as a specic
and modern face of this functional contextual tradition, with a specied
philosophy of science, a broad set of research topics, characteristic
methodological approaches, and an expansive long-term scientic goal:
creating a behavioral science more adequate to the challenge of the
human condition (Hayes, Barnes-Holmes, & Wilson, 2012; Vilardaga,
Hayes, Levin, & Muto, 2009). While CBS has been spurred on by the
establishment of ACBS, and later, the Journal of Contextual Behavioral
Science, it is worth noting that CBS is an intellectual and practical
tradition that goes well beyond any single association, journal, or
research area.
With increasing speed, CBS in its modern form has made substantive
scientic and practical progress in basic and applied areas (see Zettle,
Hayes, Barnes-Holmes, & Biglan, 2016 for a recent summary). While
initially largely focused on Acceptance and Commitment Therapy and
Training (ACT; Hayes, Strosahl, & Wilson, 1999; see Gloster, Walder,
Levin, Twohig, & Karekla, 2020 for a recent meta-analysis of
meta-analyses of ACT), Relational Frame Theory (RFT; Hayes,
Barnes-Holmes, & Roche, 2001), and behavioral principles more
broadly, CBS research and practice has expanded to include a wide va-
riety of concepts and methods relevant to both research and interven-
tion. For example, CBS research, scholarship, and practice now readily
incorporates applied evolutionary science approaches such as Prosocial
(Atkins, Wilson, & Hayes, 2019). A wide variety of functional ap-
proaches to psychotherapy such as Compassion Focused Therapy
(Gilbert, 2010), or Functional Analytic Psychotherapy (Kohlenberg &
Tsai, 2007), have long had a comfortable home in CBS. The same is true
of applied educational approaches drawn from RFT (e.g., Dixon et al.,
2017) or more generic approaches to evidence-based intervention sci-
ence such as process-based therapy (Hofmann & Hayes, 2018). This is
not an exhaustive list. A myriad of issues, topics, and methods linked by
philosophical foundations and analytic strategies live under the CBS
umbrella.
The analytic approach adopted by CBS is grounded in functional
contextual philosophical assumptions (Biglan & Hayes, 1996; Hayes &
Brownstein, 1986), which maintain that actions, public and private, can
only be understood in terms of the situational and historical contexts in
which they occur. In other words, analyses of relationships among be-
haviors broadly dened (e.g., overt actions, thoughts, feelings) or pat-
terns of behaviors (e.g., personality traits, temperaments, repertoires)
are considered incomplete without the inclusion of contextual variables
that predict psychological actions or action patterns, and the relation-
ships among them. The focus on context in CBS is driven by pragmatic
concerns, as any analysis of behavior can only be practically useful in
accomplishing prediction and inuence as a unied goal if it species
directly manipulable contexts to allow for experimental investigation
and applied intervention.
CBS encompasses a specic scientic strategy, emphasizing the
experimental analysis of principles and processes that are precise in
their analytic application, cumulatively broad in the range of phenom-
ena they encompass, and coherent with data and principles drawn from
related levels of analysis. CBS proceeds from a publicly stated goal of
seeking analyses that afford the prediction and inuence of the behavior
of whole organisms, interacting in and with a context that is considered
historically and situationally, with precision, scope, and depth. The
focus of CBS research is thus on the development of principles and
processes that are functionally dened and that apply across the full
range of behavioral complexity.
At this point, CBS research is expanding rapidly and is gaining
attention in the behavioral science community writ large. Since CBS
research includes a wide variety of topics, it difcult to characterize its
growth broadly speaking but one can do so by focusing on specic areas
that are relatively well developed within this tradition. For example, as
of March 2021, there were over 165 meta-analyses or structured reviews
of ACT, acceptance-based behavioral therapy, and the like; and over 465
published randomized controlled trials (RCTs) of ACT (see bit.ly/ACT-
metas and bit.ly/ACTRCTs). A similar proliferation of research has been
observed in terms of basic science applications. For example, analyses of
Relational Frame Theory (RFT), a CBS-consistent theory of language and
cognition, reveal growth in scholarly publications and impact of RFT
(Dymond & May 2018; Dymond, May, Munnelly, & Hoon, 2010;
O’Connor, Farrell, Munnelly, & McHugh, 2017). JCBS is now well
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
174
established and the number of authors and research laboratories pub-
lishing in JCBS is expanding.
The rise of CBS data also seems to be paralleled by the spread of CBS
ideas in a range of domains. Several major shifts within behavioral
science are in step with CBS sensitivities. For example, an increasing
number of emerging conceptual, empirical, and practical developments
emphasize the specication of core processes common across a range of
approaches (Hayes, Hofmann, & Ciarrochi, 2020). Many CBS publica-
tions and media resources created for a public audience have gained
signicant popularity, and CBS expertise and research are now regularly
featured in traditional media. CBS approaches have risen to the atten-
tion of policy makers such as the World Health Organization (WHO),
who have begun testing, promulgating, and validating CBS methods.
Early successes (Tol et al., 2018) have already led to dissemination ef-
forts linked to some of the most important problems humanity is facing
worldwide. For example, WHO is currently disseminating CBS-based
self-help to help deal with the COVID-19 pandemic (www.who.
int/publications-detail/9789240003927) and recommends ACT as a
validated treatment for chronic pain in adolescents (WHO, 2020).
Despite observed successes across various metrics, continued prog-
ress could be hampered by the poor t between underlying assumptions
that characterize CBS and dominant research standards based on more
traditional behavioral science strategies. Several examples are apparent.
For example, clinical research is often expected to focus on syndromal
diagnostic categories that tend to underemphasize contextual and
functional aspects of psychological suffering, while putting aside issues
of psychological prosperity. Assessment tools and approaches are typi-
cally evaluated in terms of traditional psychometric theory and
methods, which can be inappropriate for process-based or idiographic
approaches for which intraindividual variability is a focus. Policy
makers may restrict dissemination of intervention approaches to topo-
graphically dened packages that do not allow for person-specic
investigation of functional relationships between context and
behavior. Inductive research is often eschewed by mainstream behav-
ioral science. Infrequent self-report measures dominate over high tem-
poral density behavioral measures. Concepts and theories are
hypothetico-deductive rather than functional and analytic. Treatment
utility is de-emphasized. The link between basic and applied science is
not given explicit attention. The list of such problems goes on and on.
CBS research cannot continue to progress toward its ultimate intel-
lectual and practical purpose if it is held to standards that conict with
that very purpose. If CBS research is to make maximal impact, it is
important for the community to be clear about its research strategy and
to hold itself accountable for implementing high standards linked to its
analytic assumptions. Thus, this white paper is the product of an attempt
to foster consensus among representative producers and consumers of
CBS research on our strategies and tactics and the standards these sug-
gest in the current era of scientic work and practical development.
2. The contextual behavioral science approach
The CBS research tradition is characterized by a commitment to a
specic, pragmatic analytic purpose and strategy: specifying increas-
ingly organized statements of relations among events that permit the
prediction and inuence of any and all actions, public and private, of
whole organisms interacting in and with a manipulable context
considered historically and situationally, and to do so with precision,
scope, and depth and in keeping with testable experience. This analyt-
ical purpose and afliated strategy imply an approach that is linked to
basic principles and processes, cutting across traditionally dened areas
of study, and centered on the idiographic unit of interest, be it an in-
dividual, couple, family, small group, organization, or community (i.e.,
not a collective that differs from the unit of interest). Because principles
and processes occur at a given level of analysis or organization, nested
contextually within other levels of analysis, such an approach is inher-
ently multi-level and longitudinal. In other words, CBS analyses seek
pragmatically useful understanding of how levels of organization are
nested into larger levels, and of how sequences of action and context,
identied by appropriately temporally dense measurement strategies,
interrelate over time.
While recognizing the importance of naturalistic and observational
approaches, CBS research emphasizes analytic approaches that are
tested by experimental manipulation, seeking an appreciation of the
dynamic and complex nature of systems of inuence, and processes of
change. In part because of this appreciation, over-simplied and
reductionistic approaches that override the multi-level and multi-
dimensional nature of human complexity are rejected. Instead, high
precision, high scope analyses are sought that demonstrably improve
conceptual and treatment utility, and that integrate behavioral science
ndings and analyses into the broad family of life sciences. CBS con-
siders itself to be a facet of a multi-dimensional and multi-level extended
evolutionary approach. Adopting such an approach fosters consilience
with other perspectives by placing CBS work underneath the umbrella of
one of the most integrative and centrally important functionally and
contextually oriented theories in all of the life sciences, evolutionary
theory.
These abstract statements about science need to be tempered, how-
ever, by the recognition that science itself is a social enterprise. The Task
Force recognizes the eld’s ethical responsibility to promote research
strategies and applied methods that address the social and cultural
contexts of human action, as well as issues of diversity, inclusion, bias,
and privilege. CBS research acknowledges and aims to address bias due
to gender, language, race, ethnicity, sexual orientation, identity, class,
economics, country of origin, and the like. CBS analyses are applied to
issues of resilience and prosperity, not just pathology. Successful
implementation of the CBS scientic strategies and tactics thus requires
the participation and empowerment of practitioners, researchers, and
consumers of knowledge. In keeping with the egalitarian purpose of
CBS, self-help, peer support, and low-cost forms of prevention and
intervention across the full range of human functioning are a special
focus.
The purpose of this paper is to describe the tactics and strategies of
high-quality CBS research. The Task Force found that the key qualities of
the CBS research and practice program could be summarized around ve
key features of the approach, namely, that effective CBS research is: (1)
multi-level, (2) multi-dimensional, (3) process-based, (4) prosocial, and
(5) practical. These are all concepts that are central to CBS thinking and
an extended evolutionary model. This self-reective nature of the report
organization makes sense since the behavior of scientists themselves is
part of the purview of a CBS perspective.
In each of the areas we cover in this report, we will periodically stop
to state clearly the implications of our analysis for the goals, nature, and
needs of CBS research. These are in essence recommendations for
research that we believe will foster greater scientic progress as
measured against CBS goals and reect CBS sensibilities, at least in the
intermediate term. We recognize that these recommendations may
eventually become dated, and we encourage the ACBS Board to revisit
them when that occurs. Each recommendation will be emboldened and
numbered sequentially.
3. Contextual behavioral science is a multi-level approach
All life phenomena are nested in increasingly complex levels of or-
ganization. The cell may be part of a multicellular organism; the action
is part of a repertoire; the individual is part of a family, a community,
and so on. Analysis of human behavior is thus multi-level, with the
chosen level of analysis dened by its pragmatic purpose. For example, it
is different to study the impact of social policy on society, versus the
impact of social policy on the individual. Both are important and rele-
vant, but they answer different questions and together provide a broader
perspective. CBS research recognizes that each level of analysis has
distinct features but focuses on analyses with depth. That is, CBS
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
175
research encourages the identication of principles and processes that
can scale hierarchically across complex multi-level systems.
While a narrow focus at one level of analysis is useful at times,
viewing other levels as irrelevant and failing to situate the event of in-
terest into its broader multi-leveled context will limit scientic progress.
The result may be an inability to inuence the event of interest effec-
tively (e.g., because the analysis is incomplete), or an inability to in-
uence other levels in which the event is situated (e.g., behavioral
science informing broader social policy). Parents are key to the success
of children, for example, and they may benet from professional support
when dealing with behavioral difculties (Fung, Lake, Steel, Bryce, &
Lunsky, 2018; Gould, Tarbox, & Coyne, 2018). Failure to take into ac-
count multi-level contextual variables might also contribute to societal
inequities, bias, or stigmatization. For example, IQ and similar aptitude
tests are known for being ethno-centric, leading to inequities in college
admissions with implications for wealth accumulation among ethnic
minority populations. Conceptualizing behavior as inuenced by
multi-level contextual variables reduces misplaced blame, from recog-
nition of historical trauma to institutionalized racism, and allows
attention and manipulation of the factors that may predict and inuence
behavior.
Any given analytic focus should not diminish the relevance of other
levels of analysis. For example, CBS approaches should resist extreme
individualism, neurobiological reductionism, or the rejection of the in-
dividual as a way of emphasizing the importance of community. Clarity
of focus of analysis and a broad appreciation of the multi-level nature of
human functioning can usefully co-exist, and CBS requires a more in-
tegrated science that views events as situated in progressively larger
ecosystems (Bronfenbrenner, 1979; Kantor, 1953). Further, although
the explicit purpose of an analysis may be prediction and inuence at a
given level, because phenomena are nested, change at one level has
implications for all other levels. For example, intervening on
culture-level variables will inuence the behavior of smaller commu-
nities or individuals, and alterations in human behavior may alter gene
expression through epigenetics that may over time lead to evolutionary
changes in organism physiology, or changes in brain structure and
function within the lifetime of the person.
The multi-level nature of contextual behavioral science leads to
several research recommendations.
Recommendation 1. CBS research should examine relevant
variables across levels of analysis, facilitated by more cross-
disciplinary research, and with the explicit aim of coherence
across levels of analysis within a broad evolutionary science
framework.
Basic behavioral and applied CBS research should be acutely sensi-
tive to both content domains and contextual factors at a given level (e.g.,
interventions work for particular behaviors under particular conditions)
and across levels: both “upward” (e.g., sociology) and “downward” (e.g.,
neuroscience). For example, research in clinical psychology may focus
on the psychological level (understood within CBS to refer to behaving
organisms intersecting with and in a historical and situational context),
however, it should be sensitive to the fact that psychological events are
also nested within a specic broader social and cultural context, and
physiological, neurological, genetic and epigenetic substrates are nested
within the individual.
Multi-level analysis may be facilitated by more cross-disciplinary
research that allows for relevant contextual variables to be specied at
various levels of analysis in terms of their impact on variation and se-
lective retention of life enhancing or life interfering adjustments. By
embedding these multi-level analyses within a modern evolutionary-
science framework, psychological dimensions can more readily link
properly with ndings at other levels of analysis (e.g., biophysiological,
or sociocultural) without either reductionism or expansionism. The
purpose is a more progressive, integrated biopsychosocial science with
greater cooperation among various level of scientic research and
practice.
Recommendation 2. CBS research needs more basic experi-
mental research into sources of behavioral inuence across levels
of analysis.
Within CBS, there is a need for more basic behavioral research in
which there is the direct manipulation of context and observation of
behavior change across levels of analysis, selecting basic terms to dene
the principles that inuence behavior on the basis of their precision,
scope, and depth. For example, CBS cultural research can be usefully
informed by laboratory-based experimental analyses of cultural prac-
tices linked to basic accounts, or by the experimental analysis of com-
munity change in its natural context.
Recommendation 3. CBS research needs middle-level terms to
be examined for their utility in different contexts, and for them to
be increasingly specied and tested in basic analytic terms that
allow for the identication of multi-level inuences on behavior.
CBS often makes use of terms for pragmatic purposes as a way of
summarizing basic research and make it more practically applicable and
understandable. These so-called “middle-level terms,” situated between
basic analytic technical terms and more pragmatic or common language,
need to be subjected to ongoing evaluation in terms of their utility
specic to the contexts in which they are employed. In a progressive
research program, they also need to be increasingly well-dened over
time, via principles derived from basic research to facilitate identifying
the multi-level contextual factors that inuence them. For example, by
specifying basic analytic features of constructs such as values, self-
compassion, and the like, it may be easier to identify societal or
individual-level factors that inuence these actions. This need is espe-
cially acute when middle level terms are used that are arguably not yet
well understood in terms of a technical functional analysis.
Recommendation 4. CBS research needs to carefully measure
multi-level factors that for ethical or practical reasons cannot be
manipulated.
Contextual factors that cannot be manipulated for ethical or practical
reasons need to be adequately measured. For example, CBS research
should include assessment of the social and cultural context of in-
dividuals (within groups, families, organizations). This leads naturally
to an interest in diversity, including sex, gender identity, language,
religious beliefs, and so on, as issues of central importance. Assessment
should focus not just on the unique historical context of the individual,
but on the sets of often implicit cultural rules for behavior operating at
the group level that lead readily to oppression, inequity, and bias.
A failure to measure context is particularly problematic in random-
ized controlled trials (RCTs) and large group designs when these designs
forego the identication of contextual factors inuencing individual
outcomes. Variables inuencing outcomes may include sociocultural or
psychological-level contextual variables (e.g., individual history, neu-
rocognitive differences, social support systems) that inuence treatment
engagement or impact. Measuring and manipulating multi-level prin-
ciples, and process research at one level of analysis can speak to the
analysis of other levels. For example, empirically testing culturally
modied forms of CBS interventions in diverse populations with
adequate process measures in place can inform understanding of both
the impact of psychological intervention methods, and key features of
the social and cultural context in which psychological change occurs.
Recommendation 5. CBS research needs to emphasize more
longitudinal measurement that situates a psychological event in a
behavioral stream and the context in which that stream occurs.
CBS research should make greater use of longitudinal research with
adequately dense measurements to identify sequences of action in
context and specify how these sequences interrelate over time. This may
be facilitated by mobile technologies that allow for data to be captured
repeatedly and in real-time, sometimes with minimal burden to the
participants and in the natural environment where important psycho-
logical events are occurring. This allows behavior to be better situated in
a multi-level context, with observations nested within individuals within
a historical and situational context.
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
176
Recommendation 6. CBS research needs to focus on analyses
with depth that encourage the identication of principles and
processes that can scale hierarchically across complex multi-level
systems.
CBS research should identify principles that can scale hierarchically
across multi-level systems, allowing for greater scientic coherence and
impact. Scalable principles may increase the potential of CBS research to
positively inuence public health and solve global and social problems.
Further, research that moves beyond the individual as the unit of anal-
ysis and engages more contextual research at the population level, may
help inform public policy and maximize human potential. Research will
also be needed to examine the impact of changes at the societal level, as
well as lower levels of the multi-level system (e.g., impact of public
policy on the individual).
4. Contextual behavioral science is a process-based approach
The focus of CBS is on processes of behavioral change that allow
psychological events to be predicted and inuenced toward reaching
desired analytic, prosocial, and practical goals. Processes of change are
functionally important sequences of contextually embedded bio-
psychosocial events that can lead to positive or negative outcomes of
importance. Processes of change can refer to concepts with different
levels of precision, scope, or depth and might include:
o Basic behavioral processes, such as reinforcement, extinction,
stimulus generalization, social learning, derived relational responding,
and so forth.
o Evolutionary processes also belong in a multi-level, multi-dimen-
sional contextual behavioral approach such as genetics, epigenetic
regulation of gene expression, evolution of survival circuits, evolution of
cultural practices, phenotypical development, and the like.
o Therapeutic processes of change, expressed largely in middle-level
terms that orient analyses of behavior toward domains of importance
such as “compassion,” “acceptance,” “group identity,” or “values.” Until
fully adequate basic accounts of these middle-level terms are developed,
it is recognized that these terms may be less precisely dened than basic
behavioral processes from a CBS perspective. The middle-level terms
commonly used in CBS arguably have some degree of basic support and
at their best serve as short-hand summaries for sets of functional ana-
lyses. If these analyses are carefully done, the issue shifts from one of
precision to accessibility. Over time middle-level terms should be un-
derstood in terms of empirical analyses linked to basic behavioral and
evolutionary principles.
These different conceptualizations of processes of change may be
considered multi-leveled and their utility may vary depending on
analytical or practical purpose. For example, basic behavioral processes
may not be best suited for communicating effectively and efciently to
those outside behavioral approaches, including funding stakeholders,
non-behavioral colleagues, and even clients. Similarly, therapeutic
change processes may be too imprecise to satisfy basic behavioral re-
searchers, or even practitioners requiring more basic accounts (e.g.,
applied behavior analysts). Further, somewhat different sets of middle-
level terms may be useful based on setting (e.g., clinical vs. educational
vs. organizational), target audience (e.g., behavioral scientists vs. clients
vs. policy makers), or analytic focus (e.g., the individual person vs. small
groups). Thus, the CBS focus on processes of change fully recognizes that
the eld is not progressing toward the nal set of fully agreed upon
processes of change, and a diversity of voices should be expected and
embraced at any one time. However, CBS does aim to develop evidence-
based processes that cut across packages, protocols, and problem areas
(Rosen & Davison, 2003). Such a common language allows people
working in different settings on different problems using different
models or frameworks to communicate their results and insights.
Viewing CBS as a process-based approach leads to a series of research
recommendations.
Recommendation 7. CBS research needs basic and applied
behavioral research to identify processes of change.
Basic behavioral research will always be needed for the practical
development of CBS according to the reticulated model of scientic
development that characterizes the CBS research strategy. Without this
strong foundation, practical applications of CBS cannot develop prop-
erly. At the same time, applied research needs to identify, measure, and
test functionally important pathways of change in their natural context.
As such pathways are identied, more technical accounts of these
pathways, which reside in basic behavioral and evolutionary science
principles, will be needed to produce conceptual and practical progress
with the kind of precision, scope, and depth expected of CBS research.
Recommendation 8. CBS research needs to identify and
conceptualize intervention “kernels” using a range of basic,
applied, experimental analog, and inductive research methods.
A strong program of research is needed to identify and conceptualize
intervention “kernels” – fundamental units of behavioral inuence or
treatment elements that are not usefully divisible, and when eliminated,
render the intervention ineffective (Embry, 2004; Embry & Biglan,
2008). The identication of intervention kernels is important in order
for evidence-based intervention to be linked to individualized
process-based functional analysis. In other words, in order to meet
applied needs in a personalized way, interventions must be based on
needs, goals, decits, and skills of the individual, rather than vague or
general approaches, or mere technological collections.
It is unhelpful to allow applied psychological science to remain at the
level of extensive intervention protocols, when the spirit of idiographic
functional analysis linked to processes of change requires a more
personalized approach. A wide variety of research methods need to be
deployed to accomplish the analytic purpose of identifying intervention
kernels. Intervention kernels can be identied in component analyses,
dismantling studies, basic studies, and experimental analogs. The
interactive and synergistic interplay of intervention components needs
to be explored idiographically with appreciation for the complex net-
works involved. Inductive research, in which some manipulations of
behavioral processes are conducted, and their effects are observed,
might also be more effectively and consistently utilized. By deploying a
wide range of methods, behavioral inuence elements can be identied,
analyzed, and manipulated in a more controlled way, and their effects
tested on special problem areas or positive prosperity targets. The results
of research of this kind can inform practical applications of how to
improve behavioral change outcomes in a more efcient and effective
manner. Concentrating on fundamental units (individual treatment
components, rather than broad treatment packages) that can be actively
manipulated, may lead to unambiguous conclusions as to the active
ingredient in behavior change.
Recommendation 9. CBS research needs more behavioral and
biophysiological measures of processes of change.
Processes of change have often been measured using psychometri-
cally ltered self-report measures, especially with more “middle-level”
concepts. While self-report can be helpful, as functional analytic con-
cepts, all processes of change should have better and more widely
available behavioral and biophysiological measures, not merely self-
report. Such measures will contribute to the more basic behavioral
and evolutionary accounts of processes of change, which need to link
concepts to context in order to be fully functional. These measures
should ideally be created with the need for more high-density longitu-
dinal research in mind, as is emphasized elsewhere in this report.
Recommendation 10. CBS researchers need to conduct RCTs in a
way that fosters idiographic analyses of process of change.
In many areas of clinical research, RCTs examining treatment ef-
cacy, or the superiority of one psychological treatment in relation to
another, are weak methodologies to create the knowledge needed from a
CBS point of view. Other emphases and research designs are necessary to
efciently learn how to improve interventions, titrate their effects, and
match interventions to specic patient characteristics and situations.
When randomized group comparison designs are conducted, they should
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
177
be modied to examine processes of change more thoroughly. Tradi-
tional mediational analysis has a role to play, but it should be expanded
to focus more on the interactive, progressive, and non-linear nature of
many change processes, to link them to component methods and
contextual determinants, and to determine individual response.
Research on process of change should consider deployment of high
temporal density measures that allow greater precision in determining
how key processes change and how these changes facilitate outcomes in
a dynamic fashion.
Recommendation 11. CBS research acknowledges the need for
adaptive clinical research methods to rigorously test treatment
components.
Newer developments and innovations in trial design may increase
scientic progress in intervention research by isolating the components
of interest. Some examples of so-called adaptive designs (Pallmann
et al., 2018) include Multiphase Optimization Strategy (MOST),
Sequential Multiple Assignment Randomized Trials (SMART) and
micro-randomization designs. MOST studies are designed to speed up
the discovery of which components are active at which dose by setting
up three a priori phases (screening, rening, and conrming), at the end
of which decisions are made on how to adjust the intervention compo-
nents before continuing and re-testing. SMART studies time-vary the
sequence of intervention components to test how to best implement
components for different situations and people. Micro-randomization
refers to the randomization of different intervention components (as
opposed to randomization of people to conditions) under various con-
ditions, such that whenever the condition is triggered (e.g., after
smoking among people trying to quit) intervention components (e.g.,
warnings vs. values exercise) are randomly administered. These
research designs have in common a scientically pragmatic approach to
isolating, titrating, and testing components for different people under
different conditions. As such, these designs have the potential benet of
rendering information that is more clinically useful and contextually
sensitive than traditional RCTs comparing averaged outcomes of treat-
ment packages. It is recognized, however, that existing adaptive designs
are just the beginning of the methodological innovation that will be
needed to study how to create intentional change in a functionally and
contextually sophisticated manner.
Recommendation 12. CBS research needs more idiographic and
longitudinal, dynamic network-based research, especially in
conjunction with high temporal density behavioral and bio-
physiological measures.
Findings of relations among psychological variables based on
aggregated group data do not generalize precisely to each individual in
that same group. In other words, analyses of interindividual variability
do not yield the same ndings as one obtains from analyses of intra-
individual variability over time and across contexts. Because experience,
learning, and behavior change are highly individual matters, research
methods should involve observing them within people across time
instead of using variability in between-person observation as a false
proxy. There is a recognized need to shift from large sample size
methodology, to study methods that instead include large numbers of
observations within each individual over time, i.e., intensive longitu-
dinal designs. Intensive longitudinal designs include single case exper-
imental designs as an example, but also extend to complex network
analyses. These designs appear to be well suited to the analysis of
treatments in ways that are both process-focused and idiographic,
particularly given advancements in the use of mobile technologies
(multimedia applications, wearable sensors) for ecological momentary
assessment (EMA) and continuous real time monitoring. Intensive lon-
gitudinal designs are further supported by developments in statistical
analyses such as dynamic system approaches, cross-lagged correlation
analyses, and Simulation Modeling Analysis (Hayes et al., 2019).
Recommendation 13. CBS research needs more focus on the
empirical evaluation of interventions and intervention compo-
nents or kernels based on the degree to which they move processes
of change.
The historically central task of producing an ever-increasing list of
empirically supported treatments for designated syndromes is incon-
sistent with CBS. Rather than a sole focus on empirical tests of treatment
protocols, applied CBS research should also identify and evaluate
intervention components or kernels that move key empirically sup-
ported processes of therapeutic change. In the interests of parsimony,
these processes should ideally cut across problem areas as they have
been dened in DSM nomenclature and extend to the positive life
changes sought by recipients of care. This suggests that the empirical
support for intervention kernels, modules, and models cannot be limited
to outcomes alone, even those that are long-term, but rather require
evidence of active inuence. An applied advantage of this approach is
that idiographic impact on pathways of change provides the proximal
evidence of intervention effectiveness to guide practitioners in a more
immediate way. Capturing the temporal dynamics of processes of
change over time will require frequent session by session, day to day,
and preferably (when possible), more moment-to-moment assessment.
Otherwise, therapists are unequipped to assess, track, and customize
treatment as needed based on identied processes of change linked to
specic methods of intervention.
Recommendation 14. CBS research needs to develop alterna-
tives to traditional psychometrics as quality standards for measures
that are idiographically useful; sensitive to context; appropriate for
repeated, frequent measurement; and that emphasize observable
behavioral and biophysiological changes in addition to self-report.
While psychometrically rened instruments will continue to have
utility for some purposes, this quality lter for assessment is not well-
suited to intensive idiographic assessment and arguably contains an
ergodic error (i.e., it improperly assumes equivalence between interin-
dividual and intraindividual variability, invalidating the use of classical
statistical methods; Molenaar, 2008). The use of broad self-report in-
struments also has limitations such as sensitivity to reporting biases,
time required for completion, inadvertent combination of functionally
distinct behavior patterns, and the indirect quality of the data that
makes them a poor t for the idiographic approaches needed to mount a
successful CBS research program.
Global self-report measures used in current practice are also sus-
ceptible to cultural bias, and are often a poor t to individual needs.
Many psychological variables of interest in treatment development and
implementation are highly variable and dynamic over time within in-
dividuals. However, global self-report measures are not often designed
to detect this variation or situate it contextually. The optimal timeframe
to measure changes in process, outcome, and the interactions between
the two, has also not yet been established and may differ across contexts.
For measures to be precise and sensitive, they will need to measure the
behavior of interest or relevant biophysiological correlates frequently,
as directly as possible, and in the time and situation of interest. Alter-
native approaches are needed to determine the quality of measures that
are individualized and sensitive to context so as to track processes of
change, treatment outcomes, and relevant therapeutic factors, like
clinical competency and treatment delity in a way that is consistent
with the functional roots of CBS.
For the purpose of intensive longitudinal study of processes of
change, intervention kernels, and outcomes, measures will need to be
brief for repeated use, nonintrusive and sensitive to change. This will
require new approaches to instrument design and quality analysis that
are unlike conventional psychometric instruments design.
Recommendation 15. CBS research needs to integrate research
ndings into underlying models of applied work.
Treatment models are necessary to simplify and organize the effort to
link individual needs and goals, processes of change, and intervention
kernels. Model development is an iterative process, but it needs to be
held to account to conceptual and treatment utility. When research
ndings repeatedly show that interventions, treatment kernels, or pro-
cesses of change are not leading to desired outcomes in ways that t the
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
178
model being deployed, the model and its underlying technology require
revision or improvement. Advocates of any given process, intervention
approach, or model should be open to discard these elements when al-
ternatives are making more progress. Thus, no model or method should
be considered a permanent aspect of CBS research and practice.
Recommendation 16. CBS research needs to study processes of
change in different contexts to facilitate generalization or adapta-
tion of principles and interventions and to examine their ability to
scale across levels of analysis.
Much of the internationally published process and outcome research
has taken place in Western societies. These results may not be repre-
sentative of people from other cultures or subcultures. Furthermore,
health care may be very differently organized in different countries,
making generalizability of the procedures used problematic. For
instance, in Western societies, mental healthcare may be much more
available, with a much higher number of providers per user. Idiographic
approaches utilizing a functional analysis, case conceptualization, and
treatment delivery based on processes of change, would offer a solution
and allow for generalization and scalability of principles and in-
terventions across diverse groups, cultures, and countries. With greater
process of change research in diverse populations and contexts, models
can be developed and tested regarding how essential interventions can
be adapted for use in broad societal and cultural contexts. The same
point applies to modes of delivery. Intensive and direct delivery of ser-
vices cannot alone meet the extent of human need for behavioral sci-
ence. Technology (internet and mobile devices) supported by
professionals, semi-professionals, caregivers, peers, or others may also
be needed to deliver change interventions on a larger scale. Additional
research is needed on how to implement behavioral science research in
the most effective and efcient manner across diverse populations and
contexts.
5. Contextual behavioral science is a multi-dimensional
approach
Human life is complex, involving biological, psychological and so-
ciocultural levels of organization and multiple evolving dimensions
within these levels. The exibility of human language itself affords a
myriad of possible distinctions, but CBS research seeks out distinctions
that are heuristically useful rather than ontologically distinct. While
recognizing that any approach is neither exhaustive nor exclusive of
other possible variables, some level of organization of the many di-
mensions and domains of biopsychosocial variables is needed to support
the development of an intervention science that is sensitive to the multi-
dimensional nature of human functioning.
Many systems have been proposed for distinguishing dimensions of
human functioning and the adaptability and change processes that in-
uence them. Evolutionists such as Eva Jablonka distinguish genes,
epigenes, behavior, and symbolic behavior (Jablonka & Lamb, 2006). It
is commonplace for psychology as a eld to distinguish sensation,
perception, memory, learning, motor behavior, and so on. Skinner
(1981) distinguished genetic, behavioral, and cultural evolution. Within
behavioral psychology distinctions are also made between learned and
unlearned behavior; operantly or classically conditioned behavior;
symbolic behavior and behavior regulated by direct contingencies; and
so on. The United States National Institute of Mental Health distin-
guishes among negative valence, positive valence, cognitive systems,
systems for social processes, arousal/regulatory systems, sensorimotor
systems in their “Research Domain Criteria” (Vaidyanathan et al., 2020).
Elinor Ostrom’s core design principles, discussed later, may be
conceptualized as dimensions of successful social organization (Ostrom,
1990).
From a CBS point of view, behavior at the psychological level refers
to every situated action of the whole organism. However, distinguishing
dimensions may be scientically or pragmatically useful, depending on
the specic analytic goal of prediction and inuence. Again, that does
not mean that such dimensions are ontologically distinct, but rather that
they may be heuristically useful or organize scientic inquiry.
Existing research in processes of change has been linked to an
extended evolutionary approach by considering variation, selection,
retention, and contextual t in a loose set of six psychological di-
mensions: affect, cognition, self, attention, motivation, and overt
behavior, and considered in terms of their adaptive or maladaptive
functions (Hayes et al., 2019). Each dimension is a potential target for
change based on the processes of change engaged by psychological in-
terventions. The following rough organization is reected in the six di-
mensions of psychological exibility as generally researched in CBS
laboratories, but by stating them in a more general way the intent is to
deliberately widen the eld of view for the kinds of processes CBS
research can usefully address within each of these dimensions. It should
be noted that we have deliberately not provided specic denitions of
these dimensions since we mean them only as an orientation and we
recognize that the eld itself needs to work empirically on how best to
categorize and consider various psychological dimensions. Thus, these
dimensions should themselves currently be treated as commonly used
serviceable categories rather than fundamental distinctions within the
continuous stream of psychological activities.
Affect. Affect is perhaps the most challenging dimension to dene,
and in clinical use, it often overlaps substantially with traditionally
dened “symptoms.” For example, studies often formulate anxiety and
depression as mediators of change in therapy (Kelly, Stout, Magill,
Tonigan, & Pagano, 2010; Schmidt et al., 2018). Considering affective
outcomes of that kind to themselves be “processes of change” diminishes
somewhat the value of a process focus, since it begs the question of what
the functionally important pathways are to achieve those earlier
outcome gains. For that reason, there should be a clear demarcation
between affective outcomes and processes of change. Examples of af-
fective processes of change that maintain such a demarcation are pro-
cesses such as noticing affective responding; labeling, describing, or
tacting these responses and their qualities; establishing emotional dif-
ferentiation; learning from emotional responses; or regulation of
emotional arousal. Traditional CBS concepts such as acceptance or
experiential avoidance are primarily focused on this dimension.
Cognition. There is no simple separation between affect and
cognition, but the distinction is heuristic and is reected in CBS
research. Language and higher cognition has been extensively studied in
CBS under the rubric of relational framing. Cognitive measures offer
guidance about what is being emphasized in the intervention and may
orient toward the relative dominance of derived relations. The cognitive
dimension is perhaps one of the most well studied and includes con-
structs such as knowledge, understanding, beliefs, automatic thoughts,
problem-solving, symbolic reasoning, meta-cognition, and verbal de-
scriptions of the consequences of behavior. Cognitive processes also
differ in terms of how much they focus on the content of thought (e.g.,
dysfunctional beliefs) or the function of thought (e.g., the degree to
which a thought inuences behavior) and cognitive exibility. Tradi-
tional CBS concepts such as cognitive fusion, defusion, or rule-based
insensitivity are primarily focused on this dimension.
Attention. The attentional dimension includes actions that augment
or diminish stimulus control. At the process level, this includes selective
attention to task-relevant and irrelevant stimuli (often referred to as
attentional bias), and the ability to maintain and shift focus (e.g., xed
attention, hypervigilance and scanning). This dimension includes the
ability to focus on the present moment, which is central to concept of
mindfulness and to the psychological exibility model commonly
researched in CBS laboratories and clinics.
Self. The dimension of “self” overlaps with the other dimensions but
deserves special emphasis because of the breadth of application of this
behavioral dimension. Much of existing CBS work on sense of self has
been organized around the three-part model of self as content (i.e.,
verbal descriptions of the self; narratives about oneself or one’s history),
self as process (i.e., ongoing awareness or knowledge of one’s internal
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
179
experience), and self as context (i.e., deictic framing providing a
consistent perspective or vantage point from which all events are
experienced). Examples of processes of change in these areas include
constructs like self-esteem, self-knowledge, and decentering, respec-
tively. Basic relational skills such as perspective-taking impact self-
processes such as self-compassion (“I here, see myself there
suffering”); frames of distinction and hierarchy bear on the degree to
which the person experiences themselves as distinct from, “more than,”
or able to integrate and contain any specic experiences they may have
or observe.
Motivation. Motivation can refer to both unlearned and learned
motivative operations. When combined with relational learning, a va-
riety of verbal motivational issues arise such as autonomous motivation
vs. compliance motivation, or the degree of outcome focus. The study of
human needs, intensions, or aspirations are also examples. Traditional
CBS concepts such as values, or natural versus arbitrary reinforcers are
primarily focused on this dimension.
Overt behavior. This dimension includes overt behavioral di-
mensions such as impulsivity vs. behavioral inhibition (risk-taking vs.
risk-aversion), behavioral excesses and decits (activation vs. deacti-
vation), as well as other aspects of behavioral self-regulation (e.g., goal
setting). In a CBS approach, a central focus is the extent to which overt
actions are matched to the demands of the situation. As a perspective
grounded in a behavioral approach, in CBS, research on overt behavior is
the “bottom line” of psychological investigations.
Dyadic, social and cultural level dimensions. Dimensions also
exist at the dyadic and social/cultural level. The therapeutic relationship
is an example of a dyadic relationship embedded in a sociocultural
context. While some have posited the therapeutic relationship to be the
central mediator of all forms of therapeutic change (Priebe & Mccabe,
2008), research from CBS laboratories suggests that it is important in
part because it embodies and fosters healthy processes of change (e.g.,
Gifford et al., 2011). For example, a therapist and client are likely to
have a positive therapeutic relationship to the extent that the therapist
models and helps the client to develop better affect regulation, cognitive
exibility, attentional focus, sense of self, healthy motivation, and overt
behavioral competence.
Biophysiological level dimensions. A wide range biophysiological
dimensions are important to CBS research, including genetics, epige-
netics, neurobiological development, brain circuits, sensory systems,
and the like. Examining physiological correlates of psychological di-
mensions (e.g., heart rate variability; cortisol; and so on) are key to
testing the depth and integrative quality of behavioral science. Behav-
iors that impact biophysiological functioning such as diet, exercise, and
sleep are also key targets for CBS research.
The multi-dimensional nature of CBS research as exemplied by this
discussion leads to several research recommendations.
Recommendation 17. CBS research needs to track change in a
multi-dimensional way, using functional analytic concepts with
precision and good t to the underlying analytic purposes of a
particular research study.
There is a benet to considering human functioning broadly, and
thus there is a need to track functioning in a multi-dimensional way that
considers the various dimensions of psychological events. It needs to be
recognized however, that some change processes, such as cognitive
exibility, are fairly unidimensional while others are multi-dimensional.
For example, psychological exibility includes aspects of six different
dimensions in its classic hexagon arrangement (defusion, acceptance,
attention to the now, self-as context, values, and committed action).
Mindfulness as typically dened (e.g., Kabat-Zinn, 2003) is also multi-
dimensional and has elements of attention to the now, emotional
openness, and non-judgment. Emotion regulation can involve cognitive
aspects like reappraisal, affective aspects like non-reactivity, attentional
aspects, such as broad and exible attention in the presence of threat-
ening stimuli, and overt behavioral responses such as outward expres-
sion of emotion. CBS research should continue to rene both the
precision of concepts used, and the link between concepts and their
practical or theoretical analytic purpose. For example, a
multi-dimensional concept such as psychological exibility needs to be
shown to relate to the specic dimensions it is said to encompass in ways
that foster treatment utility. The recent development of measures that
target the various components of the hexagon model is an example
within CBS research (e.g., McCracken, 2020). Early evidence suggests
that the various components of psychological exibility are functionally
important to outcomes even in mainstream cognitive-behavioral pro-
grams (Åkerblom et al., 2021).
Recommendation 18. CBS research needs to assess the extent to
which each identied dimension can be functionally measured,
using multiple methods, and in a way that fosters successful
functional analysis.
In a CBS approach, concepts are functional and contextually
embedded. This suggests that a variety of assessment and analytic
methods are needed to examine the conceptual and clinical utility of key
concepts. Consider a concept like “reinforcement.” Merely assessing,
say, reinforcer preference would never alone be considered adequate for
an analysis of the role of reinforcement in a complex situation. It would
also require experimental analysis using overt behavioral measures. In
much the same way, a self-report of emotional openness is not an
adequate assessment of acceptance skills. It may also be important to
measure how emotionally evocative material disrupts task performance
(e.g., Luciano et al., 2014); or how willing a person is to experience
uncomfortable feelings (i.e., “tolerate distress”) in a controlled task (e.g.,
Guti´
errez, Luciano, Rodríguez, & Fink, 2004); and so on. Qualitative
methods can be helpful in ensuring that new measures maintain contact
with the contextual and experiential nature of psychological phenom-
ena. As measures of functional and contextual concepts are developed,
often using mixed methods, that need also to be vetted against the task of
individual functional analysis of actual behavior in situations of
importance.
Recommendation 19. CBS research needs to address how
different dimensions can be measured in ways that are valid at the
individual level.
As previously described, there are currently no well-crafted quality
standards for idiographic assessment, and it is clear that traditional
psychometric criteria are not enough. Advances in assessment research
and theory are needed to assess contextually embedded patterns of ac-
tion within the individual over time along different dimensions of human
psychological activity.
Recommendation 20. CBS research needs to assess the extent to
which intervention outcomes are due to various change di-
mensions at the idiographic level.
Advances are needed to link identied processes to interventions and
to do so at the level of the individual. Consider the area of statistical
mediation. Mediational analysis at present is entirely embedded in a
group comparison approach. Idiographic methods of identifying what
mediates outcomes are still at the level of theory (e.g., Hayes et al.,
2019). It is clear that traditional methods of mediational analysis are not
fully adequate, but nor are simply noting and describing process and
outcome changes at the level of the individual since these may covary
for reasons that have nothing to do with the functional importance of
processes of change. For example, if a person improves due to ACT, they
may begin talking about ACT processes in different ways that are merely
reecting socialization to the model rather than actual functional re-
lations. This is controlled for in traditional mediation by demanding that
the “b” path (the relation of process to outcome) be signicant after
controlling for treatment. Said in another way, the process needs to
relate to outcome even in the control group. This is an example of how
well worked out controls that exist at the group comparison level do not
yet have agreed upon parallels at the idiographic level. Advances in
assessment research and theory are needed that are true to the func-
tional contextual assumptions of CBS.
Recommendation 21. CBS research needs to assess the extent to
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
180
which different dimensions link to and inuence each other.
Processes of change are dynamic, progressive, and often non-linear.
It is important to understand how the many aspects of a complex set of
events interact over time. Because CBS research ultimately wishes to be
held to account to prediction and inuence as an analytic goal,“causal
variables” will ultimately need to be found in the manipulable contex-
tual/environmental determinants of relationships between various di-
mensions of responding (Hayes & Brownstein, 1986). Relating multiple
dimensions and levels of action to manipulable contextual features will
require advancements in measurement and analysis.
Recommendation 22. CBS research needs a more trans-
disciplinary approach.
The all-embracing nature of CBS research requires a more interdis-
ciplinary approach. As previously described in the multi-level section,
the psychological level of analysis is only one level, and it both impacts
and is impacted by other levels of analysis. Thus, a more trans-
disciplinary approach is needed to adequately assess different di-
mensions of human responding and the depth of concepts across levels
of analysis (i.e., coherence of psychological concepts with neuroscience,
epigenetics, sociology, and so on).
6. Contextual behavioral science is prosocial in its purpose
The rising levels of worldwide turmoil, authoritarianism, and global
climate change and many similar problems cannot be addressed by the
physical sciences alone. Selshness, greed, and apathy stand in the way
of human progress. To foster prosocial cultural transformation, behav-
ioral science is needed. Humans have an evolved capacity for verbal
behavior to help navigate and manipulate the environment, form social
bonds to enable mutual cooperation and complex collective action, and
transmit cultural knowledge, skills, and traditions across time and
generations. These capacities have enabled us as a species to not only
survive but to thrive. However, these same capacities have led to social
injustice within our society, atrocities and warfare between societies,
and damage to our natural environment, including pollution, extinction
of species, and climate change. With technological advancements, our
capacities to produce greater achievements and to cause more massive
destruction have both continued to increase in orders of magnitude. In
spite of modernization, structural racism and violence and rising ineq-
uity between haves and have nots continue to be an everyday reality in
many areas of the world.
Contextual behavioral science cannot be conducted in a vacuum,
blind to ethical and social values or its impact on society. At its most
benign, the failure to consider the prosocial purposes of CBS research is a
missed opportunity to use behavioral science to bring about positive
social change for the world. At its worst, however, CBS can be misused to
embolden or corrupt those with the most social capital, individually or
systemically, unwittingly or by design, causing greater social suffering
and oppression for the marginalized. Historical wars and genocides,
present day world conicts, and the global rise of authoritarianism
(Berberoglu, 2020) only serve to highlight the importance and urgency
of the application of science to promote the prosocial dimensions of
human behaviors.
CBS research should be prosocial in its purpose. That simple state-
ment leads to several recommendations.
Recommendation 23. CBS research needs to be explicit about its
prosocial purpose and to seek scientic knowledge that fosters
social justice.
Any organization or group with the goal to produce an account of
human behavior that permits prediction and inuence of that behavior
dened in context must contend with understanding potential social
inuences on psychological actions. In turn, if the goals of that organi-
zation or group include the promotion of prosperity, thriving, health,
and wellbeing, it must also be explicit about its interest in and study of
social justice, equity, fairness, privilege, bias and other social di-
mensions of importance. Research on Elinor Ostrom’s core design
principles and the known psychosocial factors that can promote positive
outcomes for social groups (e.g., group purpose and identity; fair dis-
tribution of responsibilities and benets; fair and inclusive decision
making; monitoring of agreed upon behaviors; graduated responses to
helpful and unhelpful behaviors; fast and fair conict resolution; au-
thority of self-govern; collaborative relations with other groups) pro-
vides an example of the kind of work that is needed to achieve CBS′
prosocial purpose. Applying such research to inequity issues is needed
going forward.
Recommendation 24. CBS research needs to address diversity
issues (gender; language; race, ethnicity; sexual orientation and
identity, etc.) in treatment and process of change research.
Researchers should be aware that as no one is without bias, and thus
assessment and intervention tools are likely to reect the bias of those
who participated in their creation. For example, process of change
measures may be biased towards certain cultures or groups of in-
dividuals. Individual differences (e.g., sex, gender identity) need to be
thoughtfully considered and assessed as potentially relevant contextual
variables for understanding and conceptualizing processes of change.
CBS researchers should actively pursue working in groups with diverse
backgrounds to prevent biases going unnoticed and detrimentally
inuencing outcome. Co-developing interventions with end-users and
other key stakeholders also has the potential to reduce overapplication
of the researcher’s perspective on the problem or the process of change.
Recommendation 25. CBS research needs to focus on conditions
that promote human cooperation.
Many of the most urgent human problems globally will require
cooperation to solve. More CBS research is needed on the development
of cooperation. There are complex dynamics between competition and
cooperation, both between individuals within a group and between
groups of individuals. Between-group competition does not necessarily
mean between-group harm, nor does multi-level selection mean that
people have to be locked in struggles with peoples with other belief
systems or other cultures. Competitive sports or the Olympics is an
example of managed competition that can foster cooperation. CBS
research should contribute evidence-based approaches to creating en-
vironments that help balance cooperation and competition for the
betterment of all.
Recommendation 26. CBS needs more research on variables that
inuence social networks for prosocial purposes.
There has been too much focus on individualism in psychological
research, even arguably within the CBS tradition (Wilson & Coan, 2021).
There is a need to expand the purview of CBS research to include the
study of social networks. Prosocial behaviors have been studied in the
context of social networks by manipulating contextual variables and
examining frequency of cooperative behaviors in various simulated
situations and economic games, such as variants of Prisoner’s Dilemma
to study cooperative behaviors (e.g., Gloster, Rinner, & Meyer, 2020).
Research has suggested that dynamic social networks, where individuals
can choose to alter the networks they are part of, tend to give rise to
increased cooperative behaviors compared to static networks (Rand,
Arbesman, & Christakis, 2011). An individual’s prosocial behaviors may
inuence others’ behaviors even outside one’s social network, some-
times cascading over several links distally (Fowler & Christakis, 2010).
Research of this kind highlights the importance of context in promoting
prosocial behaviors and the complex mutual interactions between social
network behaviors/characteristics and individual behaviors/char-
acteristics. Integrating CBS research with social research from other
disciplines (e.g., sociology) may lead to further progress in promoting
prosocial behaviors. Research might expand into new areas, such as the
application of RFT to examine the parameters of homophily or
leveraging ACT or other CBS interventions to promote cascading pro-
social behaviors.
Recommendation 27. CBS research needs to be considered
within an extended evolutionary science framework for the pur-
pose of fostering greater scientic consilience. At the same time
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
181
CBS researchers need to encourage an expansion of evolutionary
and cultural science research beyond observation and description
to include studies of inuence and change.
The contextual behavioral tradition views itself as being part of
evolutionary science, organized with a multi-dimensional and multi-
level extended evolutionary synthesis. CBS research on prosocial
behavior, processes of change, intervention components and models of
change have been connected to adaptive selection and retention because
of the consilience it provides for a functional and contextual approach.
At the same time, however, CBS research can help evolutionary and
cultural science research to expand from observation and description to
studies of inuence and change. This suggests that CBS research needs to
consciously help build a more vigorous applied wing of evolutionary
science itself.
Persons with a CBS orientation need to support evolutionary scien-
tists in conducting intervention research that is true to their assump-
tions. Applied evolutionary science does exist, but it is a small eld, and
within that, the area of cultural change is very small. CBS research can
help change that.
Cultural evolution is the domain of research that focuses on how
culture changes over time, due to different individual transmission
mechanisms and population-level effects. This approach often draws on
models derived from population genetics, in which agents are recipients
of cultural traits, but for cultural advancement to become a more central
area of research more will be required. From a functional contextual
point of view, a program of prosocial research can provide a base for
applied cultural evolutionary studies. Because manipulation of variables
so as to inuence the domain of interest is central to a CBS approach,
CBS research on cultural evolution should at times include tests of how
ethically to change conditions so as to bring about prosocial cultural
change. This experimental approach has not yet received enough
attention within evolutionary studies.
As an example, RFT has been proposed as a way of understanding
language processes within evolutionary science based on the coopera-
tive nature of humans as social primates. A useful next step may be to
examine how RFT can offer new ways of shaping prosocial human cul-
tural behavior. Currently, evolutionary and cultural scientists are mak-
ing connections between language and cultural change and CBS research
needs to further examine this issue.
7. Contextual behavioral science is a pragmatic approach
The pragmatic purpose of CBS research means that research stan-
dards and tactics should always be tempered by practicality and
measured against the ultimately practical human purposes of behavioral
science. In science, research questions are sometimes studied for their
own sake with the hope that they will eventually lead to practical ap-
plications. However, CBS involves a parallel “reticulated” relationship
between basic science and practical application. Specically, from this
perspective, the best basic science allows us to simultaneously under-
stand, predict, and inuence change in the real world, and the best
applied program readily links to and aids in a fuller understanding and
specication of basic principles. In this approach scientic progress is
measured by the breadth and depth of its pragmatic outcomes. Thus, a
dening feature of CBS research should be its practical focus. There are a
number of practical considerations to take into account in introducing
new developments in both research and practice.
Recommendation 28. CBS research needs to develop practical
research and intervention tools, focused on functionally important
processes of change, meaningful intervention goals, and user-
friendly methodological and statistical approaches that meet its
underlying assumptions.
In this report, we have emphasized the need to improve existing
nomothetically-based group comparison research and RCTs from a CBS
perspective. We recognize that these are the current gold standard
methods in applied intervention research (with grant funders and
international guidelines for evidence-based practice). This is changing,
however, with more emphasis on adaptive designs that are better suited
to a CBS approach. As we have noted earlier, from a CBS perspective, it is
important to not over-rely on RCTs when they fail to include intensive
information on individual response, or on clusters of signs and symp-
toms linked to abstractions identied at the level of a collective. Thus,
on purely practical grounds, we want to re-emphasize that from a
functional perspective, we need to continue to develop methodological,
intervention, and statistical tools that meet the underlying assumptions
of CBS and are useful, available, easy to use, and inexpensive. Virtually
every area of this report could and should be revisited with practicality
in mind.
Ironically, this practical approach has the potential to speed research
progress even at the nomothetic level. CBS research needs to develop an
“idionomographic” approach that consciously links intensive idio-
graphic analysis of individuals in the clinic or applied environment, to
nomothetic generalizations that do not distort ndings at the individual
level. CSB research needs to help develop practical idionomographic
alternatives to traditional nomothetic approaches that combine ndings
from sets of individuals into nomothetic generalizations (Hayes et al.,
2019).
Until recently, statistical approaches were not available for single
case design studies and idiographic complex networks. However, ad-
vances in statistics and research methods now allow such research to be
conducted, even embedded into RCTs. Practical analytic tools are
needed in this area so that the practice base can better facilitate research
progress. Inexpensive and turnkey data collection and analysis tools
would help speed this needed transition. CBS researchers need to help
practitioners with well-developed assessment solutions that foster
practical progress of this kind.
As noted earlier, idiographic approaches require the use of more
frequent, broader, and more contextually focused assessment methods.
For example, time series analysis, complex network models, EMA,
observation-oriented modeling (OOM), immediate therapy transcript
scoring systems, and dynamical system models are needed to provide
appropriate analytic tools for detecting individual patterns of change.
With the new capacity to collect data in real-time, such as with mobile
devices or automatic therapy transcript, recording and scoring these
approaches are at our disposal more than ever and can support meeting
the goal of identifying processes of change at the level of the individual.
CBS researchers need to develop, test, and deploy these systems to CBS
practitioners.
More widespread measures of processes in session are necessary and
can facilitate evaluating a functional approach to understanding
important processes. Examples of these could involve short self-report
instruments, or coded behaviors within treatment. The latter approach
has been used in Applied Behavior Analysis (ABA) for decades. Tran-
script analysis has yielded useful information on processes of change in
CBS research (e.g., Hesser, Westin, Hayes, & Andersson, 2009) and
machine learning approaches have begun to be applied to psychother-
apy transcript analysis (Aafjes-van Doorn, K., Kamsteeg, C., Bate, J., &
Aafjes, M., 2021). This advance will only become more and more ef-
cient as transcription and coding technology becomes more convenient,
automated, and rapid. This methodology will allow an analysis of
interactional behaviors at the level of individuals rst and that can then
be generalized to groups.
Looking at processes of change for the individual requires under-
standing the context of their behavior. Environmental and sociocultural
factors can inuence the direction and impact of treatment and vice
versa. Practical assessments of these factors are needed that can be easily
administered and valid for our purposes.
Recommendation 29. CBS research needs more cross-cultural
focus and greater attention to biases or assumptions that may in-
uence the research that is conducted and explication of its
implications.
Practical solutions need to be developed for overcoming cross-
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
182
cultural differences in the research enterprise and resulting relative
deemphasis in integrating social and cultural issues into the CBS
research program. Example challenges to be solved include language
barriers facing non-English language researchers, or language barriers
that are allowed to enter into systematic reviews, which often include
only English language work thus over-emphasizing western cultures
using primarily white middle-class individuals. Researchers need to be
aware of their own biases and worldview and understanding the socio-
political and cultural context of the behavior being studied. When
conducting research, CBS researchers need to address community issues
otherwise neglected in dominant research paradigms.
Idiographic approaches to diagnosis and treatment are relevant and
likely to be useful when issues of diversity or minority are the focus
(Fung & Lo, 2017). By bringing a bottom-up idiographic approach to the
eld of evidence-based therapy, both research and clinical goals are
altered, and if the sociocultural context of the individual is given
adequate attention and due weight at the individual and at the organi-
zational level (Fung, Lo, Srivastava, & Andermann, 2012), better
attention to these factors seems likely to follow. Researchers need to
consider whether processes of change are cross-cultural in nature or
develop a model of how specic cultural variables interact with these
change processes.
Recommendation 30. CBS research needs to maximize the
external validity of research by including key stakeholders in the
research enterprise.
The practical impact of research and even of research strategy needs
to be strengthened. Practitioners and participants need more voice in
determining the research questions that need to be addressed and out-
comes that are valued (e.g., quality of life; social functioning). Stake-
holder Steering Groups (SSGs) are a positive example and as a result they
are becoming more widely required for inclusion in applications by large
scale funders. We also need to ensure that research results that are
effective in meeting human needs are adopted and used. For example,
while set treatment protocols for specied syndromes has rigor at the
level of research design, it is not practical in practice to meet the needs of
diverse practitioners or their clients and may only apply to the narrow
set of conditions in which it was studied, and the narrow range of syn-
dromal outcome toward which it was targeted. Implementation science
frameworks can be used to examine contextual adaptation in diverse
real-world settings.
Recommendation 31. CBS research needs to focus on how best
to train CBS researchers and practitioners.
In a CBS approach, scientists and practitioners are themselves subject
to the same analysis as others. That is, an analysis of the manipulable
contextual variables that inuence key repertoires involved in produc-
ing quality CBS research and providing quality CBS interventions.
Practical and effective methods of creating quality CBS researcher and
practitioners should therefore be a continuing focus. Because CBS
methods are part of a wide variety of domains and disciplines, this
recommendation needs to be scaled across a number of tools, such as in
person trainings, degree programs, online courses, apps, websites, sup-
port groups, supervision structures, feedback systems, and the like.
Recommendation 32. CBS research needs to help ensure that
research that meets human needs is promulgated and used.
It is not enough to do research; rather its value to the community
requires promulgation and utilization. CBS research is needed to
determine how best to disseminate behavioral science tools in ways that
can actually improve peoples’ lives. Many scientic developments and
treatments never reach the general public or become integrated into
professional practice or public policy. It is essential that we determine
how best to increase access to evidence-based care, and particularly how
to reach underserved populations. Several recommendations in this
report help to serve this end. CBS researchers need to continue to work
with key stakeholders to maximize the acceptability and utility of in-
terventions, to examine the degree to which research reects the values
of end-users, and to identify and support processes that predict or
inuence effective utilization of scientic ndings. Creative use of
implementation science methodologies and the establishment of CBS
research programs focused on the issue of promulgation and use are
necessary to create the kind of cascading effects needed for scientic
advances to benet a signicant number of human lives.
8. Concluding remarks
Contextual behavioral science has roots that go back to the beginning
of behavioral science and psychology. The recommendations presented
in this report are a snapshot of research needs as the 20th century fades
into memory and the remaining decades in the 21st century begin to
loom large. CBS is not dened by a single theory, method, topic, disci-
pline, or person. It is a communitarian knowledge development strategy
based on a set of philosophical assumptions, an evolving set of research
practices, and a growing body of applied methods that are relevant to
nearly every area of human functioning. The goal of CBS is breathtak-
ingly bold: creating a behavioral science more worthy of the challenge of
the human condition. We cannot claim that goal has been met; we do not
know if it ever will be. But bold journeys are best linked to bold goals.
CBS research has a publicly stated purpose, and these recommendations
are meant as means to facilitate accomplishing those goals. Thus, our
nal recommendation is this:
Recommendation 33. The CBS community should foster the
recommendations of the ACBS Task Force on the Strategies and
Tactics of Contextual Behavioral Science Research in their labora-
tories, classrooms, scientic reports, and applied agencies. ACBS
should foster these recommendations in association policy, asso-
ciation conferences and committees, and in association publica-
tions such as the Journal of Contextual Behavioral Science. In due
time, the CBS community should revisit, review, and refresh these
recommendations as part of an ongoing process of attempting to
create a behavioral science more worthy of the challenge of the
human condition.
Declaration of competing interest
A number of the Task Force members serve on the editorial board of
the Journal of Contextual Behavioral Science, or on the Board of Directors
of the Association for Contextual Behavior Science, or on committees
linked to the Journal or to recommendations in this report including the
Publications Committee. All authors of the Report wish to afrm that
they had no involvement in the peer-review of this article and had no
access to information regarding its peer-review.
In addition, while many of the authors write books, have grants, or
offer training in areas related to Contextual Behavioral Science and thus
to the issues discussed in this Report, none of the recommendations of
this Report are linked to commercial products, and none of the authors
have specic conicts of interest to report that may have impacted their
recommendations.
Appendix A. Task Force Recommendations
The Task Force recommendations in list form can be found online at
https://doi.org/10.1016/j.jcbs.2021.03.007.
References
Aafjes-van Doorn, K., Kamsteeg, C., Bate, J., & Aafjes, M. (2021). A scoping review of
machine learning in psychotherapy research. Psychotherapy Research, 31(1), 92–116.
https://doi.org/10.1080/10503307.2020.1808729
Åkerblom, S., Perrin, S., Rivano Fischer, M., et al. (2021). Predictors and mediators of
outcome in cognitive behavioral therapy for chronic pain: The contributions of
psychological exibility. Journal of Behavioral Medicine, 44, 111–122. https://doi.
org/10.1007/s10865-020-00168-9
Atkins, P., Wilson, D. S., & Hayes, S. C. (2019). Prosocial: Using evolutionary science to
build productive, equitable, and collaborative groups. Oakland, CA: Context Press/New
Harbinger Publications.
S.C. Hayes et al.
Journal of Contextual Behavioral Science 20 (2021) 172–183
183
Berberoglu, B. (Ed.). (2020). The global rise of authoritarianism in the 21st Century: Crisis of
neoliberal globalization and the nationalist response. New York: Routledge. https://doi.
org/10.4324/9780367854379.
Biglan, A., & Hayes, S. C. (1996). Should the behavioral sciences become more
pragmatic? The case for functional contextualism in research on human behavior.
Applied and Preventive Psychology: Current Scientic Perspectives, 5, 47–57. https://doi.
org/10.1016/S0962-1849(96)80026-6
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and
design. Boston: Harvard University Press.
Dixon, M. R., Belisle, J., McKeel, A., et al. (2017). An internal and critical review of the
PEAK relational training system for children with autism and related intellectual
disabilities: 2014–2017. The Behavior Analyst, 40(2), 493–521.
Dymond, S., & May, R. (2018). Quantifying the empirical growth of relational frame
theory research: A cautionary note. Psychological Record, 68, 255–260. https://doi.
org/10.1007/s40732-018-0278-z
Dymond, S., May, R. J., Munnelly, A., & Hoon, A. E. (2010). Evaluating the evidence base
for relational frame theory: A citation analysis. The Behavior Analyst, 33(1), 97–117.
Embry, D. D. (2004). Community-based prevention using simple, low-cost, evidence-
based kernels and behavior vaccines. Journal of Community Psychology, 32, 575–591.
Embry, D. D., & Biglan, A. (2008). Evidence-based kernels: Fundamental units of
behavioral inuence. Clinical Child and Family Psychology Review, 11, 75–113.
Fowler, J. H., & Christakis, N. A. (2010). Cooperative behavior cascades in human social
networks. Proceedings of the National Academy of Sciences, 107(12), 5334–5338.
https://doi.org/10.1073/pnas.0913149107
Fung, K. P., Lake, J., Steel, L., Bryce, K., & Lunsky, Y. (2018). ACT processes in group
intervention for mothers of children with autism spectrum disorder. Journal of
Autism and Developmental Disorders, 48(8), 2740–2747.
Fung, K. P., & Lo, H. T. (2017). An integrative clinical approach to cultural competent
psychotherapy. Journal of Contemporary Psychotherapy, 47, 65–73.
Fung, K. P., Lo, H. T., Srivastava, R., & Andermann, L. (2012). Organizational cultural
competence consultation to a mental health institution. Transcultural Psychiatry, 49
(2), 165–184.
Gifford, E. V., Kohlenberg, B., Hayes, S. C., et al. (2011). Does acceptance and
relationship-focused behavior therapy contribute to bupropion outcomes? A
randomized controlled trial of FAP and ACT for smoking cessation. Behavior Therapy,
42, 700–715.
Gilbert, P. (2010). Compassion Focused Therapy: Distinctive Features. New York: Routledge.
Gloster, A. T., Rinner, M. T. B., & Meyer, A. H. (2020). Increasing prosocial behavior and
decreasing selshness in the lab and everyday life. Scientic Reports, 10, 21220.
https://doi.org/10.1038/s41598-020-78251-z
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The
empirical status of acceptance and commitment therapy: A review of meta-analyses.
Journal of Contextual Behavioral Science, 18, 181–192. https://doi.org/10.1016/j.
jcbs.2020.09.009
Gould, E. R., Tarbox, J., & Coyne, L. (2018). Evaluating the effects of Acceptance and
Commitment Training on the overt behavior of parents of children with autism.
Journal of Contextual Behavioral Science, 7, 81–88. https://doi.org/10.1016/j.
jcbs.2017.06.003
Guti´
errez, O., Luciano, C., Rodríguez, M., & Fink, B. C. (2004). Comparison between an
acceptance-based and a cognitive-control-based protocol for coping with pain.
Behavior Therapy, 35(4), 767–783. https://doi.org/10.1016/S0005-7894(04)80019-
4
Hayes, S. C., Barnes -Holmes, D., & Roche, B. (2001). Relational Frame Theory: A Post-
Skinnerian account of human language and cognition. New York: Plenum Press.
Hayes, S. C., Barnes-Holmes, D., & Wilson, K. G. (2012). Contextual behavioral science:
Creating a science more adequate to the challenge of the human condition. Journal of
Contextual Behavioral Science, 1, 1–16. https://doi.org/10.1016/j.jcbs.2012.09.004
Hayes, S. C., & Brownstein, A. J. (1986). Mentalism, behavior-behavior relations and a
behavior analytic view of the purposes of science. The Behavior Analyst, 9, 175–190.
Hayes, S. C., & Hofmann, S. G. (2018). Process-based CBT: The science and core clinical
competencies of cognitive behavioral therapy. Oakland, CA: Context Press/New
Harbinger Publications.
Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2020). A process-based approach to
psychological diagnosis and treatment: The conceptual and treatment utility of an
extended evolutionary model. Clinical Psychology Review, 82, 101908. https://doi.
org/10.1016/j.cpr.2020.101908
Hayes, S. C., Hofmann, S. G., Stanton, C. E., Carpenter, J. K., Sanford, B. T., Curtiss, J. E.,
et al. (2019). The role of the individual in the coming era of process-based therapy.
Behaviour Research and Therapy, 117, 40–53. https://doi.org/10.1016/j.
brat.2018.10.005
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An
experiential approach to behavior change. New York: Guilford Press.
Hesser, H., Westin, V., Hayes, S. C., & Andersson, G. (2009). Clients’ in-session
acceptance and cognitive defusion behaviors in acceptance-based treatment of
tinnitus distress. Behaviour Research and Therapy, 47, 523–528. https://doi.org/
10.1016/j.brat.2009.02.002
Jablonka, E., & Lamb, M. J. (2006). Evolution in four dimensions: genetic, epigenetic,
behavioral, and symbolic variation in the history of life. Cambridge, MA: MIT Press.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and
future. Clinical Psychology: Science and Practice, 10, 144–156.
Kantor, J. R. (1953). The logic of modern science. Bloomington: Principia Press.
Kelly, J. F., Stout, R. L., Magill, M., Tonigan, J. S., & Pagano, M. E. (2010). Mechanisms of
behavior change in alcoholics anonymous: Does alcoholics anonymous lead to better
alcohol use outcomes by reducing depression symptoms? Addiction, 105(4),
626–636.
Kohlenberg, R. J., & Tsai, M. (2007). Functional Analytic Psychotherapy: Creating intense
and curative therapeutic relationships. New York: Springer.
Luciano, C., Valdivia-Salas, S., Ruiz, F. J., Rodríguez-Valverde, M., Barnes-Holmes, D.,
Dougher, M. J., et al. (2014). Effects of an acceptance/defusion intervention on
experimentally induced generalized avoidance: A laboratory demonstration. Journal
of the Experimental Analysis of Behavior, 101, 94–111. https://doi.org/10.1002/
jeab.68
McCracken, L. M. (2020). Psychological exibility in chronic pain: Exploring the
relevance of a process-based model for treatment development. In S. G. Hofmann, &
S. C. Hayes (Eds.), Beyond the DSM: Toward a process-based alternative for diagnosis
and mental health treatment (pp. 199–223). Oakland, CA: Context Press/New
Harbinger Publications.
Molenaar, P. C. M. (2008). On the implications of the classical ergodic theorems:
Analysis of developmental processes has to focus on intra-individual variation.
Developmental Psychobiology, 50, 60–69.
O’Connor, M., Farrell, L., Munnelly, A., & McHugh, L. (2017). Citation analysis of
relational frame theory: 2009–2016. Journal of Contextual Behavioral Science, 6(2),
152–158. https://doi.org/10.1016/j.jcbs.2017.04.009
Ostrom, E. (1990). Governing the commons: The evolution of institutions for collective action.
Cambridge, UK: Cambridge University Press.
Pallmann, P., Bedding, A. W., Choodari-Oskooei, B., et al. (2018). Adaptive designs in
clinical trials: Why use them, and how to run and report them. BMC Medicine, 16, 29.
https://doi.org/10.1186/s12916-018-1017-7
Priebe, S., & Mccabe, R. (2008). Therapeutic relationships in psychiatry: The basis of
therapy or therapy in itself? International Review of Psychiatry, 20(6), 521–526.
https://doi.org/10.1080/09540260802565257
Rand, D. G., Arbesman, S., & Christakis, N. A. (2011). Dynamic social networks promote
cooperation in experiments with humans. Proceedings of the National Academy of
Sciences, 108(48), 19193–19198. https://doi.org/10.1073/pnas.1108243108
Rosen, G. M., & Davison, G. C. (2003). Psychology should list empirically supported
principles of change (ESPs) and not credential trademarked therapies or other
treatment packages. Behavior Modication, 27(3), 300–312.
Schmidt, S. J., Lange, M., Sch¨
ottle, D., Karow, A., Schimmelmann, B. G., & Lambert, M.
(2018). Negative symptoms, anxiety, and depression as mechanisms of change of a
12-month trial of assertive community treatment as part of integrated care in
patients with rst- and multi-episode schizophrenia spectrum disorders (ACCESS I
trial). European Archives of Psychiatry and Clinical Neuroscience, 268(6), 593–602.
Skinner, B. F. (1981). Selection by consequences. Science, 213, 501–504.
Tol, W. A., Augustinavicius, J., Carswell, K., Leku, M. R., Adaku, A., Brown, F. L., et al.
(2018). Feasibility of a guided self-help intervention to reduce psychological distress
in South Sudanese refugee women in Uganda. World Psychiatry, 17, 234–235.
https://doi.org/10.1002/wps.20537
Vaidyanathan, U., Morris, S., Wagner, A., Sherrill, J., Sommers, D., Garvey, M., et al.
(2020). The nimh research domain criteria project: A decade of behavior and brain
integration for translational research. In S. G. Hofmann, & S. C. Hayes (Eds.), Beyond
the DSM: Toward a process-based alternative for diagnosis and mental health treatment
(pp. 23–46). Oakland, CA: Context Press/New Harbinger Publications.
Vilardaga, R., Hayes, S. C., Levin, M. E., & Muto, T. (2009). Creating a strategy for
progress: A contextual behavioral science approach. The Behavior Analyst, 32,
105–133.
Wilson, D. S., & Coan, J. (2021). Groups as organisms: Implications for therapy and
training. Clinical Psychology Review, 85, Article 101987. https://doi.org/10.1016/j.
cpr.2021.101987
World Health Organization. (2020). Guidelines on the management of chronic pain in
children. Geneva: World Health Organization.
Zettle, R. D., Hayes, S. C., Barnes-Holmes, D., & Biglan, T. (2016). The Wiley handbook of
Contextual Behavioral Science. Chichester, UK: Wiley/Blackwell.
S.C. Hayes et al.
