Cognitive-behavioral treatments are often described in step-by-step manuals. They provide strategies for treating a specific psychological disorder or diagnosis as opposed to addressing the specific problems and symptoms of a particular person.
Manualized treatments may fall short as they tend to adopt a general approach to treatment versus creating a specific approach tailored to each client.
Over the years, acceptance and commitment therapy (ACT) has grown and evolved, in part, due to the unique contributions of the clinicians who use it. The freedom within the framework is one feature that makes ACT so effective.
Many of my clients come in initially wanting some specific “thing” that will fix their problems: they want to simply do X action and get Y result.
I imagine my clients are not unique in this. We live in a world of fad solutions to our problems, where with every moment something new and shiny vows to change our lives for the better. “Just do this one thing,” it promises. Until the next thing comes along.
The main questions for behavior analysis are which factors, in a given historical situation, influence what someone does, and how these factors can be changed in order to affect behavior. The relationship between a specific act and the context in which it occurs is the point of interest.
Clinicians often integrate multiple therapeutic models to enhance their capacity to assist their clients. However, integration can be problematic without a disciplined, evidence-based approach to decision making.
Mixing models also raises the concern of losing treatment efficacy by deviating from validated protocols, something weakly supported by evidence, but still worth considering (see Koerner, 2018 for important insights about this concept).