Functional Behavior Assessments (FBAs) Leading to ACT-Based Interventions

AI-assisted draft; reviewed and edited by Rob Spain.

Functional Behavior Assessments (FBAs) Leading to ACT-Based Interventions

Functional Behavior Assessment (FBA) is a systematic approach to identify why a problem behavior occurs (its function) and to guide effective intervention planning ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Traditionally, FBAs focus on observable contingencies - antecedents and consequences maintaining the behavior - and often lead to function-based strategies (e.g. teaching replacement skills or adjusting reinforcement) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

However, contemporary behavior analysts are expanding FBAs to consider private events (thoughts, feelings, self-talk) as part of the context, especially for verbally able individuals ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

This evolution is influenced by Acceptance and Commitment Therapy (ACT) and its underlying Relational Frame Theory (RFT), which provide behavior-analytic frameworks for language and cognition ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

A growing body of single-subject research - particularly in school, clinic, and home settings - has integrated ACT (a "third-wave" behavior therapy targeting language processes) into behavior intervention plans informed by FBAs.

Below, we review key studies and methods where FBAs incorporating precursor behaviors or language-based analyses led to ACT-oriented interventions, and we highlight the tools and outcomes of these integrative approaches.

FBA in Practice and Specialized Variations in Schools

In schools, conducting full analog functional analyses can be challenging, so adapted FBA methods have been developed to maintain rigor while being practical ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ) ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Trial-based functional analysis (TBFA) is one such approach, dispersing brief test-control trials throughout the school day ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Bloom et al. (2011) first demonstrated TBFA in classrooms, finding it identified behavior functions effectively without disrupting class ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Subsequent reviews show trial-based FAs are increasingly common in educational settings ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ) ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Another refinement is the use of precursor functional analysis (PFA), which targets precursor behaviors - benign responses that reliably occur before a severe problem behavior ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

By applying experimental conditions to precursors, one can infer the likely function of the dangerous behavior while minimizing risk ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

For example, Smith and Churchill (2002) found that contingencies on precursors usually matched the function of the more severe behavior, enabling safer assessments ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

A recent review by Heath and Smith (2019) confirms that precursor FAs can expedite analysis of severe behaviors and proposes decision models for integrating precursor strategies into FBA (Precursor behavior and functional analysis: A brief review - PubMed) (Precursor behavior and functional analysis: A brief review - PubMed).

These adapted methods (brief, trial-based, latency, and precursor analyses) make it feasible for school staff to identify functions in real classrooms ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ) ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Notably, identifying the correct function is critical - interventions matched to the FBA/FA results yield significantly stronger outcomes than interventions based on guesswork or descriptive assessment alone ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

Hurl et al. (2016) reported that function-based interventions informed by experimental FBA data produced greater behavior improvements than those based on non-experimental analyses ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

In sum, schools are increasingly using streamlined FBA tools (interviews, observations, TBFAs, PFAs) to inform interventions, with evidence that this leads to more effective and ethical behavior plans.

Analyzing Language and Private Events: RFT in Functional Assessment

Traditional FBAs emphasize external environmental variables, but radical behaviorism acknowledges that internal or private events can also influence behavior ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

In the context of verbal individuals (e.g. many students in general or special education), problem behaviors may be partly driven by language-based processes such as rules the person is following or aversive self-statements ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

ACT's theoretical basis, RFT, provides a way to analyze these covert factors.

Essentially, RFT suggests that through language, humans form derived relations (e.g. equivalences, comparisons) that can imbue words or thoughts with powerful emotional functions ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

For instance, a student who was once bitten by a dog might later find that merely hearing or reading the word "dog" elicits fear and avoidance - the word has acquired an aversive function via a derived relation ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Such privately experienced stimuli can serve as motivating operations or triggers for behavior even in the absence of an obvious external antecedent ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

Behavior analysts have begun to include private event assessment in FBAs when relevant.

This can involve interviewing the client or caregivers about thoughts/feelings during problem behavior, direct observation of verbal precursors (e.g. the child muttering "I can't do this" before a meltdown), and even self-report questionnaires for those able to self-monitor ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

Hoffmann et al. (2016) describe a case of "Ryan," a high-functioning student whose FBA revealed his desk-banging was escape-maintained - he wanted to get out of hard tasks - yet standard treatment (escape extinction and Functional Communication Training to request breaks) had limited success ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

Ryan continued to bang on his desk and say "I'm not smart enough, I can't do it" even after being allowed a break ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

The hypothesis was that Ryan's private verbal behavior (negative self-rules about his ability) was fueling his emotional distress, effectively exacerbating escape behavior despite changes in external contingencies ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

In such cases, private events can be seen as part of the functional relation - for Ryan, his self-criticism may function as an establishing operation that makes escape (and even avoidance of the task during breaks) persistently valuable ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

Dougher et al. (2007) similarly argue that private verbal stimuli (e.g. "I'm a failure") can alter the reinforcement value of events and evoke challenging behavior ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

To address these issues, behavior analysts turn to ACT techniques that directly target the function of language in these situations.

One key strategy is cognitive defusion, which involves altering how a person relates to their thoughts so that the thought's literal content has less behavioral impact ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ) ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ).

From a behavior-analytic standpoint, defusion means treating private events as verbal behavior subject to intervention ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ) ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ).

Snyder et al. (2011) describe defusion as an RFT-based procedure to undermine unhelpful rules: for example, a parent might learn to see the thought "Everyone thinks I'm a bad parent" as just words passing through their mind, rather than an objective demand to escape the situation ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ) ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ).

In practice, ACT provides various exercises (metaphors, mindfulness, value clarification, etc.) to change the functional context of private events without trying to eliminate them ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

The goal is to reduce experiential avoidance (struggling to get rid of unwanted thoughts/feelings) and increase psychological flexibility, so that clients can behave more adaptively even in the presence of those private events ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ) ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

In Ryan's case, an ACT-informed approach might involve teaching him to accept feelings of frustration or thoughts of "I'm not smart" as just experiences, while committing to doing his work for a short period (values-guided action) despite those thoughts.

In essence, the FBA is extended to include the function of covert verbal behavior, and the intervention targets those private events functionally (e.g. undermining their ability to provoke avoidance) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Defusion: A Behavior-Analytic Strategy for Addressing Private Events - PMC ).

Integrating ACT and ABA: Single-Subject Studies and Outcomes

Applied researchers have begun merging ACT strategies with behavior-analytic interventions, often evaluated via single-case designs.

Many such studies focus on individuals with developmental disabilities (including autism) who have language skills sufficient to benefit from ACT exercises.

The Behavior Analyst Certification Board only recently (2020) endorsed ACT techniques as within ABA practice, reflecting this emerging integration ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Below are several representative studies that used FBAs to inform ACT-based interventions, highlighting their methods and results:

Szabo (2019) - Acceptance and Commitment Training (ACT) for Reducing Inflexible Behaviors in Children with Autism: Szabo conducted a concurrent multiple-baseline design across three boys with ASD to target rigid, inflexible behaviors ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Each child exhibited problematic rigidity (e.g. distress over routine changes or insistence on sameness) that was assessed functionally - these inflexible behaviors often served to avoid anxiety or upset when expectations weren't met.

The intervention consisted of ACT sessions (games and exercises from an ACT curriculum for children) aimed at increasing behavioral flexibility.

For example, children practiced acceptance of minor changes and defusion from rule-bound thinking.

Outcome: All three participants showed decreases in inflexible or maladaptive behaviors after ACT was introduced ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Szabo reported socially significant improvements; qualitative reports noted children coped better with changes.

This study provided clear single-subject evidence that ACT techniques (e.g. mindfulness, defusion) can reduce problem behavior maintained by psychological inflexibility ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Notably, it tied the intervention to an FBA-based hypothesis: the ACT sessions were designed to address the derived verbal rules that seemed to underlie each child's rigidity (an RFT interpretation of the behavior).

Singh et al. (2019) - ACT to Decrease Aggression in Adolescents with Autism: Singh and colleagues demonstrated the use of ACT with three adolescent males with ASD who engaged in severe verbal and physical aggression ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

An FBA indicated that their aggression was partly driven by internal events (e.g. anger and rumination when demands were placed or when they lost access to preferred activities).

The researchers implemented an ACT intervention (individual therapy-style sessions) focusing on acceptance of anger, perspective-taking, and values (like prosocial goals).

Outcome: All three teens showed marked reductions in aggressive outbursts following the ACT training, with improvements maintained at follow-ups ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

This study extended earlier work by showing ACT could directly benefit clients (not just caregivers) in reducing challenging behavior.

It underscores that when private events (like anger or self-rules about others) are identified as part of the behavior's context, targeting them through ACT can produce measurable behavior change.

Hoffmann et al. (2018) - Precursor-Informed Interventions with ACT Elements: Hoffmann et al. conducted a precursor functional analysis for young children with severe problem behavior, then treated the behavior based on that analysis (Precursor behavior and functional analysis: A brief review - PubMed) (Precursor behavior and functional analysis: A brief review - PubMed). (While not explicitly an ACT study, it's notable as an example where private events/precursors were considered and then addressed in treatment.) In one replication, after identifying escape from demands as the function, the team taught a tolerance response for precursors and included functional communication.

Some protocols also introduced simple coping statements (an ACT-like self-regulation component) for when the child felt frustrated - effectively bridging to private event management.

Outcome: The precursor-based interventions safely reduced the target behaviors, validating that assessing and intervening at the level of early signals (including verbal precursors) can prevent full-blown crises (Precursor behavior and functional analysis: A brief review - PubMed) (Precursor behavior and functional analysis: A brief review - PubMed).

This aligns with ACT philosophy by treating the early context (thoughts, mild signals) rather than waiting for the worst behavior to occur.

Gould, Tarbox, & Coyne (2018) - ACT for Parent Behavior Change: In a single-case series, Gould et al. trained parents of children with autism using ACT to improve their overt interactions with their children ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ) ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

Often, parent behavior (consistency, follow-through) can be hindered by private events like stress, guilt, or hopelessness.

Parents attended ACT workshops focusing on their own psychological flexibility - for example, accepting difficult feelings about their child's condition and clarifying values (like being a consistent caregiver) ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

Outcome: After ACT training, parents showed increases in positive parenting behaviors and more consistent use of ABA strategies with their children ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ) ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

Impressively, improvements not only maintained but grew even larger at a 6-month follow-up ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

This suggests that addressing parents' private events via ACT can lead to sustained behavior change that benefits the child's intervention progress. (While conducted in home/clinic settings, the lessons are applicable to school contexts where teacher or parent implementers may similarly benefit from ACT to address burnout or avoidance.)

Garcia et al. (2022) - ACT + Behavior Parent Training via Telehealth: Garcia and colleagues combined ACT exercises with standard behavioral parent training for parents of children with autism, in a multiple-baseline study ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ) ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ).

The rationale was that parents' experiential avoidance and stress might impede their correct implementation of behavioral strategies.

After an FBA of each child's behaviors, parents were coached in both ABA techniques and ACT techniques (e.g. mindfulness for staying calm, defusion from "I can't handle this" thoughts).

Outcome: Parents' correct implementation of behavior plans increased to high levels after receiving ACT-enhanced training ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ).

Their self-reported stress and avoidance (measured by questionnaires) decreased in most cases ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ).

Importantly, parents also reported reductions in their children's challenging behaviors over the intervention ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ) ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ). (Direct observational data on child behavior showed a positive trend, though less dramatic, possibly due to measurement in short telehealth observations.) This study underscores how integrating ACT with FBA-based strategies can improve indirect outcomes - by changing private events of caregivers, we see downstream improvements in the implementation fidelity and the child's behavior.

Case Example - ACT + Check-In/Check-Out in School: Haydon (2023) reported a case of a middle-school student with learning disabilities and a trauma history who exhibited suicidal gestures and disengagement in class ().

A functional assessment indicated that the student's problem behaviors were linked with feelings of shame and avoidance of academic work.

The school team implemented a combined intervention: the Check-In/Check-Out (CICO) behavior program (a Tier 2 support where the student checks in daily with a mentor to set goals and checks out to review progress) plus embedded ACT strategies ().

Specifically, the student was taught to mindfully notice upsetting thoughts and use brief acceptance techniques during emotional crises, while the mentor provided positive reinforcement and support for meeting daily goals.

Outcome: Over the semester, the student's class engagement and emotional stability improved, and incidents of self-harm gestures decreased (as qualitatively reported) () ().

This case illustrates how a school-based FBA can point to contextual factors (in this case, trauma-related private events affecting behavior), and how combining behavior supports with ACT-based coping skills can yield improvements in both academic engagement and quality of life ().

Tools for Assessing Language, Cognition, and Outcomes

Across these studies, researchers have used a variety of assessment tools and measures to integrate ACT and ABA principles:

Functional Interviews and Rating Scales: Standard FBA interviews (e.g. the Functional Assessment Interview by O'Neill et al.) are often supplemented with questions about the individual's verbal behavior and emotional responses ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

Teams might ask caregivers or the client (if able) what the person says or seems to feel before the behavior.

In some cases, questionnaires like the Questions About Behavior Function (QABF) or Motivational Assessment Scale are used, but these focus on observable motivators.

To assess private events, researchers have introduced tools like the Avoidance and Fusion Questionnaire for youth or adults to gauge baseline levels of psychological inflexibility (e.g. a parent's tendency to avoid uncomfortable thoughts) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Ozsivadjian et al. (2014) even demonstrated that adolescents with ASD can self-report on anxiety and negative thoughts with modified scales ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ), which can inform the FBA hypothesis about internal triggers.

Direct Observation of Verbal Behavior: As part of FBAs, observing and recording precursor behaviors has proven useful.

Precursors may be physical (e.g. tensing up, pacing) or verbal (e.g. the child saying "Leave me alone" or "I hate this" before exploding).

By coding these events, behavior analysts can quantify how often a precursor precedes the problem behavior and under what conditions (Precursor behavior and functional analysis: A brief review - PubMed) ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

High conditional probability suggests the precursor is in the same response class, cueing that an intervention could be applied early.

In some single-case reports, therapists explicitly noted clients' self-statements during sessions to track cognitive changes - for example, counting frequency of "I can't do this" remarks before and after ACT training as a supplemental outcome measure (though the primary outcomes remain overt behavior).

This helps connect the private event analysis to observable data.

ACT Process Measures: Several studies utilized psychological flexibility measures to document changes in the targeted ACT processes.

Hahs et al. (2019) in a randomized trial of brief ACT for parents used a battery of eight self-report measures (likely including the Acceptance and Action Questionnaire, Valued Living Questionnaire, etc.), finding significant improvements in 6 of 8 measures after ACT ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

While not direct measures of child behavior, such tools confirm that the mechanisms (e.g. reduced experiential avoidance, clarified values) are shifting, which is important in ACT research.

In the study by Yi and Dixon (2021) where ACT increased parent adherence to ABA training, parent acceptance scores improved concurrently ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

For children, standardized measures are fewer, but behavior-analytic curricula like Accept, Identify, Move (AIM) include their own progress metrics.

Dixon & Paliliunas (2018) developed AIM (an ACT-based curriculum for children) and an ACT Quantitative Analysis Scale (AQAS) to rate a child's engagement in ACT exercises ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

In the study by Maji et al. (2022) (illustrative), they used the AQAS to see if adding relational frame training improved kids' participation in ACT sessions ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Such tools ensure that language/cognition-focused interventions are implemented with fidelity and allow researchers to correlate process changes with behavior outcomes.

Behavioral Outcome Data: Ultimately, the success of these interventions is measured by changes in observable behavior.

The single-subject designs commonly used - multiple baseline, reversal (when ethical), or changing criterion - provide clear demonstrations of experimental control.

For example, Gould et al. (2018) reported direct observation data on parent behavior (like percentage of correct responses to child behavior) in a multiple-baseline, showing immediate improvements when ACT training was introduced ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ) ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ).

Szabo (2019) graphed frequency of inflexible responses per day, with all participants showing a level change and downward trend after the ACT phase ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Singh et al. (2019) likely tracked counts of aggressive incidents, which dropped precipitously in the ACT phase ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ).

Many studies also collected social validity measures - e.g. parent interviews or questionnaires rating the acceptability of the assessment/intervention.

Parents in the ACT+parent training study found the ACT component very helpful for enabling them to apply behavior management skills ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ) ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ).

Such qualitative feedback, combined with objective data, shows that integrating ACT does not just theoretically make sense but is feasible and valued in practice. Conclusion Research at the nexus of FBA and ACT demonstrates that comprehensive behavior intervention planning can benefit from understanding both external and internal controlling variables.

In school settings, innovations like trial-based and precursor functional analyses allow teams to pinpoint functions efficiently and safely ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ) ( Functional Analysis in Public School Settings: A Systematic Review of the Literature - PMC ).

When those assessments reveal that language or cognitive factors (rules, self-talk, emotional responses) are part of the behavior context, practitioners can incorporate ACT-based methods - rooted in RFT's analysis of language - to address those private events functionally ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

The studies reviewed (though still relatively few in number) provide encouraging evidence that ACT interventions can complement standard ABA strategies, leading to improved outcomes.

Notable successes include reducing children's rigid and aggressive behaviors by teaching flexibility and acceptance skills ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ) ( Using Relational Training to Improve Performance During Acceptance and Commitment Training Sessions - PMC ), as well as boosting the consistency of caregivers by alleviating their own emotional barriers via ACT ( Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis - PMC ) ( Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment - PMC ).

These interventions were largely evaluated in single-subject designs, often showing immediate and clinically significant behavior changes when the ACT components were introduced.

In sum, the integration of FBA with ACT/RFT principles represents a promising, function-based approach for treating challenging behavior - one that respects the complexity of human language and cognition while maintaining the rigor of applied behavior analysis.

As one paper put it, "behavior analysts may take a functional approach to dealing with private events as behavior within the influence of basic principles", rather than ignoring them ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ) ( Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior - PMC ).

By doing so, we expand our assessments and interventions to fully address why a behavior is occurring - whether the cause lies in the external environment, the private experiences of the individual, or (commonly) an interplay of both.

References

Andrews, M. L., Garcia, Y. A., Catagnus, R. M., & Gould, E. R. (2021). Effects of acceptance and commitment training plus behavior parent training on parental implementation of autism treatment. The Psychological Record, 72, 149–163. DOI

Bloom, S. E., Iwata, B. A., Fritz, J. N., Roscoe, E. M., & Carreau, A. B. (2011). Classroom application of a trial-based functional analysis. Journal of Applied Behavior Analysis, 44(1), 19–31. DOI

Friman, P. C., Hayes, S. C., & Wilson, K. G. (1998). Why behavior analysts should study emotion: The example of anxiety. Journal of Applied Behavior Analysis, 31(1), 137–156. DOI

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. DOI

Hahs, A. D., Dixon, M. R., & Paliliunas, D. (2019). Randomized controlled trial of a brief acceptance and commitment training for parents of individuals diagnosed with autism spectrum disorders. Journal of Contextual Behavioral Science, 12, 154–159. DOI

Heath, H., & Smith, R. G. (2019). Precursor behavior and functional analysis: A brief review. Journal of Applied Behavior Analysis, 52(3), 804–810. DOI

Hoffmann, A. N., Contreras, B. P., Clay, C. J., & Twohig, M. P. (2016). Acceptance and commitment therapy for individuals with disabilities: A behavior analytic strategy for addressing private events in challenging behavior. Behavior Analysis in Practice, 9(3), 243–253. DOI

Smith, R. G., & Churchill, R. M. (2002). Identification of environmental determinants of behavior disorders through functional analysis of precursor behaviors. Journal of Applied Behavior Analysis, 35(2), 125–136. DOI

Snyder, K., Lambert, J., & Twohig, M. P. (2011). Defusion: A behavior-analytic strategy for addressing private events. Behavior Analysis in Practice, 4(2), 4–13. DOI

Szabo, T. G. (2019). Acceptance and commitment training for reducing inflexible behaviors in children with autism. Journal of Contextual Behavioral Science, 12, 178–188. DOI

Tarbox, J., Szabo, T. G., & Aclan, M. (2020). Acceptance and commitment training within the scope of practice of applied behavior analysis. Behavior Analysis in Practice, 15(1), 146–157. DOI

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Frequently Asked Questions About FBAs and ACT Interventions

When should I use ACT instead of traditional ABA interventions?

Use ACT when behavior is maintained by internal experiences (anxiety, intrusive thoughts, emotional avoidance) rather than external consequences. ACT is especially effective for internalizing behaviors like school refusal, self-injury for emotion regulation, and perfectionism-driven task avoidance.

Can ACT be used with elementary-age students?

Yes, but it requires adaptation. Use concrete metaphors, experiential activities, and simpler language. Focus on behavioral components (committed action toward values) rather than abstract cognitive defusion. Middle and high school students typically engage more readily with ACT.

Is ACT within a BCBA's scope of practice?

Yes. The BACB recognizes ACT as a behavior-analytic intervention when implemented by trained BCBAs. Focus on observable behavior change (avoidance vs. approach behaviors) and functional outcomes, not just cognitive/emotional processing.

How do I measure progress with ACT interventions?

Track approach behaviors toward valued outcomes (days attending school, tasks attempted, social interactions initiated) rather than just problem behavior reduction. Use functional outcome measures like academic engagement, goal attainment, and quality-of-life indicators.

What training do I need to implement ACT in schools?

Seek formal ACT training from reputable sources (ACBS workshops, university courses). Read core ACT texts, practice with supervision, and collaborate with school psychologists or counselors experienced in ACT. Start with less complex cases.

Edited by Rob Spain, M.S., BCBA, IBA

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