Functional-analytic psychotherapy (FAP) is a form of behavior therapy that emphasizes the use of the therapist-client relationship in order to fully utilize the learning opportunities that arise in the therapeutic session (e.g., in vivo intervention ). Based on radical behaviorism According to BF Skinner, FAP produces change through natural and healing contingencies of reinforcement that occur within an emotional, close, and highly involved therapist-client relationship.
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Kohlenberg and M. Tsai found that some of their clients treated with conventional cognitive behavioral therapy techniques experienced notable improvements that went beyond the initial objectives of the treatment. In searching for the causes of this phenomenon, they observed that these notable progress occurred in those patients with whom an intense and committed therapeutic relationship4 had been established.
As a result of this experience, Kohlenberg and his group applied behavioral concepts to:
Explain the connection between dramatic improvements and an intense therapeutic relationship
Outline the procedure to follow to facilitate these intense and potentially healing bonds
Kohlenberg and Tsai stated that FAP, a powerful treatment in its own right, is also an integrative approach that can be combined with virtually any other type of therapy with synergistic results. It should also be noted that FAP’s emphasis on the therapeutic relationship based on behavioral theory has some unintended similarities with the Freudian concept of transference, as well as with the idea that there may be “hidden meanings” beneath the surface of statements made by patients during the consultation.
Development of Functional Analytical Psychotherapy
The PAF greatly values ​​in-vivo learning opportunities, that is, the actual emergence of the patient’s problems in their interaction with the therapist. The patient is seeking treatment for problems of daily living, and in doing so acts in the same dysfunctional way in the clinical context, therefore the therapist must be attentive to detect clinically relevant behaviors. We can distinguish three types of clinically relevant behaviors within therapy.
The relevant type 1 behaviors (CCR1) are those behaviors related to the problem that the client presents in the session and whose frequency must be reduced throughout the therapy.
The clinically relevant type 2 behaviors (CCR2) are the behaviors that occur in the session and that represent an improvement in relation to the problem for which the consultation is sought.
The clinically relevant behaviors type 3 (CCR3) are the client’s interpretations of their own behavior. Along with these, descriptions of functional equivalence are also included that indicate similarities between what happens in the session and your daily life.
FAP employs several therapeutic strategies. The three main ones are: Be alert to the appearance of CCR, b) cause CCR and c) reinforce CCR2.
*Strategy 1: Attention to clinically relevant behaviors (CCR). This strategy is the most important since it alone leads to a more intense and effective treatment.
A therapist skilled in CRC screening also tends to be more able to naturally encourage and incentivize clients to abandon self-blaming patterns that appear in vivo and, therefore, increase more productive approaches to life.
* Strategy 2: Cause CCR2. Since the occurrence of CRC is indicated for FAP, how can the therapist promote its appearance? Reconstruction of the client’s behavioral problems in a behavioral trial, as mentioned, is not the same as the natural onset of CRC. Similarly, faking ad hoc situations, such as arriving late for a consultation or getting angry with a client, is not recommended, as it is incongruent with the honest and close relationship that the PAF suggests.
*Strategy 3: Strengthen CCR2. Reinforcement is a technical term that in this context refers to the care and strengthening that the therapist exercises on the improvements that occur in the consultation. It is advisable to rely on the therapist’s natural reactions instead of using stereotyped sentences like “that’s great!” or “great!”, which may be seen by the client as a lack of sincerity. Expert PAF therapists are aware of CCR2 emergence as they occur and are spontaneously and genuinely reinforcing.
Conclusions
On the other hand, therapists who are not aware of CCRs can inadvertently punish CCR2 (e.g. therapeutic progress). Let’s consider a case of a patient who seeks help for depression related to the lack of assertiveness she demonstrates with her husband.
The therapist she saw tried to teach her to be more assertive using behavioral rehearsals, a common behavior therapy procedure. The patient said she was uncomfortable with the behavioral test and asked if there was another way to approach the problem.
The therapist then suggested to the patient that resisting the behavioral rehearsal was a sign of avoidance and urged her to continue doing it anyway. The PAF analysis of this episode indicates that the patient’s refusal to perform the trials is a CCR2, since she has been assertive with the therapist in doing so, that is, the same real-life skill that he was trying to teach her. The therapist besides, did not encourage or strengthen this assertiveness, and may have even inadvertently punished her by accusing her of avoiding and insisting on completing the behavioral test.
This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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