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Functional Analytic Psychotherapy (FAP): A review of publications from 1990 to 2010
Victor Mangabeira1, Jonathan Kanter2, & Giovana Del Prette3 1 Universidade de São Paulo, 2University of Wisconsin-Milwaukee, & 3Institute of Psychiatry - Universidade de São Paulo; Núcleo Paradigma Abstract
Functional Analytic Psychotherapy (FAP), a therapy based on radical behaviorism, establishes the priority of the therapeutic interaction as a mechanism of change in psychotherapy. Since the first book on FAP appeared in 1991, it has been the focus of many papers and has been incorporated by the community of behavior therapists. This paper is a review of 80 international publications on FAP from 1990 to 2010, including publications from Brazil, the United States, Spain, Switzerland and Colombia. The goal was to analyze how FAP has been treated and developed across these 20 years, and also to propose some directions for further studies. The analysis suggests a diverse range of FAP publications, points to the necessity of more empirical studies with tighter control of variables and objective measurement of data to better understand FAP’s process and effectiveness, and highlights the importance of increased communication between international research groups to increase the potential benefits of singular and collective research efforts on FAP.

Functional Analytic Psychotherapy, literature review


unctional Analytic Psychotherapy (FAP), a model for psychotherapy based on radical behaviorism first developed by Kohlenberg and Tsai in 1991 (translated into Portuguese in 2001), proposes that the therapeutic relationship is the primary context for behavioral change in the therapeutic process for clients with interpersonal problems (Kohlenberg & Tsai, 2001; Kohlenberg, Tsai & Kanter, 2009). The authors suggest that everything the therapist needs and can use to help clients through the change process occurs during the session, in the therapeutic relationship. Specifically, FAP encourages the therapist to identify three classes of client clinically relevant behavior (CRB) occurring in session: CRB1, defined as behavioral problems occurring in session; CRB2, defined as behavioral improvements or progress in session, and CRB3, defined as the client’s descriptions about the functional controlling variables of his behaviors (both inside and outside the session). FAP systematizes five rules around which the therapist should base treatment, including: (1) Observe the occurrence of CRBs, (2) Evoke CRBs, (3) Reinforce CRB2s, (4) Observe the reinforcing effects of therapist behavior on CRBs, and (5) Provide interpretations about the variables that affect client’s behavior (Tsai et al, 2009). Since the FAP book appeared in 1991, many theoretical and empirical papers have appeared. These papers have been quite diverse. For example, several studies have been conducted to demonstrate how to use FAP combined with other interventions (Callaghan, Gregg, Marx, Kohlenberg, & Gifford, 2004; Gaynor & Lawrence, 2002; Kohlenberg, Kanter, Bolling, Parker, & Tsai, 2002). Follette and Callaghan (1995) and Callaghan (2006) discussed supervision in FAP, and described what they consider a more efficient way to conduct FAP supervision. Busch and col78

leagues (2008) performed an empirical micro-process analysis of FAP’s mechanism of change. Oshiro (2011) also investigated the mechanism of change using interventions based on FAP, with an ABAB experimental design. Follette, Naugle and Callaghan (1996) presented important theoretical contributions to understand how FAP’s therapeutic relationship can function as a mechanism of change in therapy. Callaghan, Summers and Weidman (2003) used FAP to treat a client with Histrionic and Narcissistic Personality Disorder. These examples demonstrate the diversity of writings on FAP that have appeared. Despite this diversity of publications, FAP has been criticized for producing too many theoretical articles making claims of FAP efficacy, without supportive empirical studies (Corrigan, 2001), and for not yet having conducted a randomized controlled trial to support FAP’s efficacy (Öst, 2007). According to Öst (2007), there continues to be a lack of empirical data for the validation and wide acceptance of FAP as an efficacious intervention. A comprehensive review of papers on FAP has yet to be performed. In particular, previous reviews (e.g., Baruch et al., 2009; Corrigan, 2001; Öst, 2007) have been limited to only Englishlanguage publications, while we were aware of important publications on FAP in Portuguese coming out of Brazil, as well as in other languages. Thus, the current review made an effort to survey the global literature on FAP, not just English-language literature. Recently, Garcia (2008) included some Portuguese language publications in his review of FAP studies, which categorized FAP papers into six categories: integration with other therapies, supervision and improving therapeutic skills, methods for evaluation and data recording in therapy, studies of effectiveness and efficiency, experimental investigations into the

Psychology (VHL-PSI). In addition to case study designs. including G. b) Country of author’s and 7) Group designs. 7) Obsessive Compulsive Disorder. 2) Case Studies Type I that present some objective data. 3) ACT. the Virtual Health Library . and 14) Comparison of CBT or CT with FAP. We also emphasize the international and developmental nature of the publications. . the final sample consisted of 80 articles. The publications were organized into three pre-defined categories (bibliographic characteristics. Schneider. M. as well as authors and/or countries with the highest production of research on FAP. In addition to these databases. Empirical publications received this categorization when the publication presented any data type (including case reports). 4) Group therapy based on FAP. 2) Adolescent. ScienceDirect and ISI Web of Knowledge. San Jose State University). Finally. 9) Supervision based on FAP. 2011. we identified: a) Type of study. 11% appeared twice and 15% had three or more publications (average of 2. search engines were reviewed for relevant publications in the Journal of Applied Behavior Analysis (JABA). 11) Efficacy studies of FAP. 1994. R. Portuguese or Spanish. The theoretical studies were composed of publications that presented and/or discussed the FAP as a proposal for intervention. 2) Rating systems. With respect to thematic characteristics. In the current review. identified with an asterisk in the reference list. Scholz. Regarding Interventions performed. the articles were classified as either theoretical or empirical. 2005. four case study sub-categories were defined using the classification scheme proposed by Kazdin (1982. 11) Abuse problems in interpersonal relationships. and application to clinical problems and new types of applications. The final period of data collection took place in July. but did not have any data about the use of FAP. „ RESULTS AND DISCUSSION BIBLIOGRAPHIC CHARACTERISTICS The 80 articles that comprised the bibliographic database included a total of 90 different authors (including first authors and coauthors). http://functionalanalyticpsychotherapy. From these sources. 2003. we expanded on the review by Garcia (2008) and conducted a comprehensive international search for FAP publications from 1990 to 2010. and 3) Adult. 1993) that classifies case study data according to the degree to which the data presented addresses risks to the internal validity of the conclusions: 1) Narrative case studies that report on a case but present no objective data. Journal of the Experimental Analysis of Behavior (JEAB). 9) Nonspecific Personality Disorder.36 publications per author). Callaghan (15 publications. 6) Manipulation of conditions of type A/B/A+B. The Behavior Analyst Today. 14) Anxiety and academic performance. „ METHOD BIBLIOGRAPHIC BASE The following sources of virtual access information were consulted: PubMed. 13) Borderline Personality Disorder. each with a series of subcategories identified for analysis. We also consulted references listed on the FAP website. 6) Development of an instrument based on FAP. 1 During the review process we were made aware of four additional papers on FAP (Dougher & Hackbert. Regarding themes. This analysis indicated that the systematic study of FAP is dominated by several specific research groups. the publications were categorized with respect to research methods. The keywords “Functional Analytic Psychotherapy” were used in all searches. 5) Histrionic Personality Disorder. 1993): 5) Manipulation of conditions of type A/A+B.FUNCTIONAL ANALYTIC PSYCHOTHERAPY (FAP): A REVIEW OF PUBLICATIONS 79 relationship between thoughts and emotions. and c) Intervention performed. Twelve other categories were created. Regarding measurement instruments. The Behavior Analyst. 2010). and with members of a FAP email listserve for additional articles. three predefined subcategories were used: 1) Child. thematic characteristics and research methods). divided into: a) Design. Further analysis of the full text was conducted when the article was available (70 of 80 articles). 8) Therapy for children and adolescents based on FAP. and 7) BA + FAP. to fully evaluate the empirical status of FAP and its mechanism of change. 12) Conduct Disorder. J. 5) Integration of therapies. and 15) Exhibitionism. c) Journal name. 10) Substance abuse. An objective was to identify different phases in research on FAP at different times between 1990 and 2010. the following research design categories were created also based on Kazdin (1982. 5) FAP + ACT. We included articles from international periodicals in three languages: English. 10) Analysis of empirical data on FAP. and 4) Systematic observation of sessions. 3) Characterization of FAP. and 4) Case Studies Type III that include repeated objective measurements from two or more subjects. 8) Chronic pain resistant to treatment. 2) Treatment using FAP. We conclude with discussion of future directions for research and practice in the area. 3) Case Studies Type II that include repeated objective measurements. 4) CBT + FAP. Regarding type of study. 13) Couples therapy based on FAP. 3) Non-systematic observation of sessions. 6) Group FAP. d) Name of the authors and e) Number of authors. six sub-categories included: 1) FAP. International Journal of Behavioral Consultation and Therapy (IJBCT) and Journal of Early and Intensive Behavior Intervention (JEIBI). 12) Training therapists in FAP. 2) CBT. The majority of authors (74%) appeared only once in the database. the Scientific Electronic Library Online (SciELO). we identified: a) Year of publication. four sub-categories were included: 1) Scales and standardized questionnaires. Regarding design. We discuss research methodologies employed in the publications on FAP. With regard to client characteristics. 7) Comparison of ACT with FAP. Books or chapters were excluded. publications had their main themes categorized and sub-categories that emerged from this analysis were: 1) Contributions from FAP. b) Measurement instruments. These papers have been included in the reference list for the readers’ information but have not been included in the analyses.1 METHOD OF ANALYSIS The abstracts of the selected publications were analyzed to obtain the necessary data for this categorization. With respect to bibliographic characteristics. including: 4) Major Depression. and c) Client characteristics. 6) History of childhood sexual abuse. b) Themes. Shingler & Strong.

for the five-year period between 1990 and 1995 there were 5 FAP publications. between 2001 and 2005 there were 22 publications. and the Behavior Therapist. L. Spain. In Brazil. Specifically. In Brazil. it may indicate specific interests in FAP that do not continue after initial publications. although some newer research is coming out of the lab of Sonia Beatriz Meyer at the University of São Paulo. Pontifícia Universidade Católica de Goias). both produced by the Behavior Analyst Online organization. Vandenberghe (16 publications. A number of journals have received only one FAP publication. the most productive FAP author was Luc Vandenberghe with 16 publications while in Spain the most productive author was Rafael Ferro García with 14 publications. Cumulative curve of publications on FAP between 1990 and 2010. University of Washington). Some American universities that present themselves as the core of studies of FAP are: San Jose State University. The analysis of authors’ countries of origin indicates that more than half (51%) of publications were authored by authors from the United States of America (USA). An alternate way to demonstrate this growth in the rate of FAP publications is to break the history into five year periods. In Brazil. & DEL PRETTE Figure 1. which could help in labor efficiency as well. produced by the Brazilian Behavioral Psychology and Medical Association. This increase also support the hypothesis that a greater number of authors are interested in exploring FAP and may suggest a large number of publications over the coming years if this trend continues. the University of Washington and the University of Wisconsin-Milwaukee. Both Switzerland and Colombia appear with one publication each. University of Wisconsin-Milwaukee) and one Brazilian. the newsletter publication of the Association for Behavioral and Cognitive Therapies. W. The distribution of 80 articles from five countries shows that the efforts to explore FAP are highly concentrated in small centers of study.80 MANGABEIRA. demonstrating good acceptance of FAP in Brazil but making it difficult to dialogue with other authors and study centers across the world. A final bibliographic analysis considered the journals in which FAP articles have been published (Table 1). The fact that we found several authors who have published only once may indicate a growing interest in FAP. supporting the second hypothesis. Brazil and Spain both produced 24% of the total publications each.e. including its originators Robert J. between 1996 and 2000 there were 16 publications. . Improved communication and exchanges between these nuclei of FAP therapists and researchers can strengthen the work. Garcia is located at the Center for Clinical Psychology CEDI in Granada. J. and the acceleration of the curve indicates a growth in the number of publications over time. alternately. Kohlenberg (14 articles) and Mavis Tsai (10 articles). onepublication authors were observed throughout the 20 year study period. Figure 1 presents the cumulative number of FAP publications between 1990 and 2010. nearly half of the Brazilian articles were published in the national journal. Kanter (11 publications. Kohlenberg (14 publications. and written in Portuguese. It is likely that these articles by one-publication authors may be the result of isolated research (i. the University of Nevada-Reno. There is a predominance of publications in the journals The Behavior Analyst Today and the International Journal of Behavioral Consultation and Therapy. masters or doctoral degree research). In fact. KANTER. In Spain. and between 2006 and 2010 there were 37 publications. the primary center of study has been Vandenberghe’s Catholic University of Goiás. the country of FAP’s origin. Revista Brasileira de Terapia Comportamental e Cognitiva.. and it would be desirable to carry out integrated research.

This increase in empirical work is an expected result if we take into consideration that the natural course of development of interventions initially involves theoretical analysis and then empirical testing and validation. shows the distribution of theoretical and empirical studies with the country of the authors. However. As suggested by Corrigan (2001). the largest empirical study on FAP appeared. and Moura and Conte (1997) are among the Brazilians that have published theoretical articles. a low number of empirical studies is found in the current analysis. Spain. the Spanish empirical publications provide empirical objective data and greater experimental control. we examine the distribution of theoretical and empirical publications by authors’ countries of origin. these Brazilian empirical studies mostly consist of unsystematic case reports with no objective data and manipulation of variables. second in the number of publications. while empirical studies occurred mostly in the last 10 years and appear to be on the increase. Unlike in Brazil. Figure 3. One can see that most of the publications had as the themes the issues of contributions or characterization of FAP. which in fact occurred in most theoretical studies. Kohlenberg. Theoretical publications are present throughout much of the period between 1990 and 2010. . Cross.FUNCTIONAL ANALYTIC PSYCHOTHERAPY (FAP): A REVIEW OF PUBLICATIONS 81 Table 1. although the authors noted that the study was not a randomized trial. Bolling. Vandenberghe. Specifically. Number of FAP Publications by Journal Journal International Journals The Behavior Analyst Today International Journal of Behavioral Consultation and Therapy The Behavior Therapist Análisis y Modificación de Conducta Behavior Therapy Journal of Consulting and Clinical Psychology Cognitive and Behavioral Practice Psicothema The Behavior Analyst Clinical Case Studies Counseling Psychology Quarterly International Journal of Clinical and Health Psychology Journal of Psychotherapy Integration Apuntes de Psicología Clínica y Salud Revista de La Asociación Española de Neuropsiquiatría Psychotherapy Psychotherapy Research Behavior Modification Clinical Psychology & Psychotherapy Clinical Psychology Review Journal of Applied Behavior Analysis Journal of Trauma Dissociation Psychotherapy: Theory/Research/Practice/Training EduPsykhé European Psychotherapy Journal of Feminist Family Therapy Journal of Mental Health Papeles del Psicólogo Professional Psychology: Research & Practice Psicologemas Psicología Conductual Behaviour Research and Therapy Brazilian Journals Revista brasileira de terapia comportamental e cognitiva Estudos de Psicologia (Campinas) Psicologia: Teoria e Prática Terapia Psicológica Torre de Babel Psicologia Clínica 5 1 1 1 1 1 8 7 5 4 4 4 3 3 3 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Number of Publications THEMATIC CHARACTERISTICS Type of study. perhaps indicating a current concern to obtain empirical evidence for FAP in clinical interventions. Overall. there are a greater number of theoretical FAP publications (58%. As some of these issues are not mutually exclusive. as discussed below. Bermudez. presents more theoretical than empirical publications. The country with the largest number of publications is the USA with mostly theoretical publications. In Figure 3. the number of empirical studies was greater than the number of theoretical studies. as will be discussed in below. as will be discussed later. some publications were categorized with more than one of these themes. The results. N = 34). Parker and Tsai (2002) compared Cognitive Therapy for depression with FAP-Enhanced Cognitive Therapy for 46 clients and found promising results for FAPEnhanced Cognitive Therapy. and Iron (2003) are among the Brazilians who have published empirical studies. shows a greater number of empirical studies. For example. Brazil. N = 46) compared to empirical publications (42%. below. and the mere existence of empirical publications does not mean that their reliability is high. Garcia and Aguayo (2010) presented a case of FAP with a client diagnosed with depression. The major themes identified are presented in Table 2 below. Kanter. below. between 2001 and 2005. During this time. while empirical studies mostly had as a main theme the treatment of clients using FAP and the integration of therapies. It is interesting to note also that in the third period. Figure 2. showed significant improvement in depressive symptoms and maintenance of gains but no control over alternative explanations for the findings. analyzed using the Beck Depression Inventory II (BDI . like the USA.II). shows the distribution of theoretical and empirical publications over the period between 1990 and 2010.

2006c). Interestingly. the Functional Analytic Psychotherapy Rating Scale (FAPRS.82 MANGABEIRA. 2006b). 2008). Number of theoretical and empirical publications by year of publication in 5-year intervals. four studies were dedicated to the development of instruments based on FAP aimed for use in future research and to provide clinical guidance. & DEL PRETTE Figure 2. These instruments are proposed to categorize Figure 3. . Distribution of theoretical and empirical studies by authors’ countries of origin. Among the tools developed are the Functional Idiographic Assessment Template (FIAT. Follette & Callaghan. and the Functional Assessment of Skills for Interpersonal Therapists (FASIT. Cal- laghan. Callaghan. KANTER.

suggesting very little control over inter- Figure 4. chronic pain. These data support the hypothesis that FAP authors view FAP as quite flexible as an intervention and future research may benefit from exploring the possible uses and limitations of FAP across a range of conditions. the overwhelming majority of publications focused on depression (16). and problems in interpersonal relationships) and one publication (sexual abuse in children. Anorgasmia. to categorize therapist and client speech in FAP according to the five rules (FAPRS). academic anxiety. and therapist failures to respond appropriately to CRB. The FAPRS also measures the occurrence of client CRB. The FAPRS was designed to facilitate the analysis of interactions in FAP and consequently the production of empirical data on FAP. therapist responses to CRB. Among these studies is that of Gosch and Vandenberghe (2004) that presented FAP with a defiant-aggressive child with promising results. For example. and nonspecific anxiety disorder). More research to validate FAP as an intervention for children would be of great value (Del Prette. and a small minority (12%) studied FAP for children and adolescents. followed by Histrionic Personality Disorder (3). including therapist attempts to evoke CRB. Conduct Disorder. Substance abuse. nonspecific personality disorder. Most of the publications were categorized as narrative case studies. Number of Publications According to the Main Theme Presented Main theme FAP contributions Total 39 27 25 7 6 1 4 4 3 5 5 4 1 3 Interventions using FAP FAP characterization Integration of therapies Group therapy based on FAP Comparison between CBT and FAP Development of an instrument for FAP Comparison between ACT and FAP Child/adolescent therapy based on FAP FAP supervision Analysis of empirical data about FAP Efficacy study of FAP Therapist training based on FAP Couples therapy based on FAP client CRBs (the FIAT). . Distribution of empirical publications by design category. Agoraphobia. and a variety of disorders and conditions represented by two publications (Obsessive Compulsive Disorder. When analyzing the types of psychiatric disorders focused on in FAP publications. Callaghan and Follette (2008) created the FAPRS to capture relevant aspects of the therapeutic interaction. Exhibitionism. Borderline Personality Disorder (2). 2011).FUNCTIONAL ANALYTIC PSYCHOTHERAPY (FAP): A REVIEW OF PUBLICATIONS 83 Table 2. and to measure FAP therapist skills in supervision (FASIT). and has been used in a number of studies. METHODOLOGICAL CHARACTERISTICS Figure 4 shows the distribution of empirical publications by design category. The vast majority (88%) of the articles focused on FAP with adults.

Kanter. Kanter. Baruch. Landes. Empirical studies categorized as “Case Study Type II” and A / A + B designs are also frequent. and Tsai (2002) used a group design and repeated objective measures for each group and thus was characterized both as a Case Study Type III and Group Study.84 MANGABEIRA. Although most of these studies were narrative case studies without much control. Mauritius and Goulin (2009). These authors used this design to examine the effects of FAP added to cognitive behavioral therapy on clinically relevant behaviors of two depressed clients. Although this study represents an advanced design relative to the existing research. such studies are often the result of clinicians who work closely with FAP and these studies may provide important clinical guidance. Maeoka. These data support the idea that researchers are increasingly concerned with the production of empirical data and validation of FAP. et al. The authors suggest that the drop out may be related to some aversive procedures used in FAP. The results indicated that one client improved during the A + B stage when FAP was introduced while the other dropped out of therapy after FAP was introduced. Mendes and Vandenberghe (2009) describe a successful course of FAP with a 47-year old patient diagnosed with obsessive-compulsive disorder. As pointed out by Öst (2007). Brown. They used the FIAT system and a protocol for identifying clinically relevant behaviors. Parker. nal validity of the data presented (Kazdin. 1993). but neither provide generalizable data. For example. Bolling. Callaghan. this is a major weakness with respect to knowledge about FAP. The results indicated that the therapist identified more CRB2s with the introduction of FAP in the supervision and the authors suggest that this increases the likelihood of the therapist to positively modify the behavior of the client. Studies that used A/A+B designs can verify the effects of FAP added to traditional therapies. Rusch. Stradioto. (2006). It is interesting to note the existence of only one group study which was not a randomized trial (Kohlenberg. suggesting an increase in empirical research on FAP in the last 10 years. Distribution of publications by design during 5-year periods between 1990 and 2010. Busch. KANTER. The first exhibit some control over threats to internal validity because they have objective repeated measurement. For example. More controlled designs are absolutely necessary. Bolling. even this design did not involve random assignment of clients to conditions and thus is quite limited. These authors conducted an A/B study on the training of a therapist in traditional behavioral therapy and FAP and investigated the effects of FAP on the therapist’s ability to identify clinically relevant behaviors of the client. & DEL PRETTE Figure 5. it is important that more rigorous designs become more frequent in FAP research. although much still needs to be done. Figure 5 shows the distribution of publications over 5-year intervals by design category. In general. Parker & Tsai. Research involving many participants is difficult to perform without funding and an alternative to this would be more investment in better single-subject research de- . Kohlenberg. An example of this type of design is Kanter. An example is Silveira. but there is no objective data thus we cannot speak with confidence that FAP was successful nor can we assume the results are generalizable to other cases. 1982. However. we may say that some efforts have been made to validate FAP. discuss the difficulties of conducting controlled FAP research in the clinic and suggest other self-report measures particularly for differentiating client avoidance. 2002).

An example can be found in Vandenberghe and Iron (2005). In contrast. Sixteen of the 20 instruments found were scales and standardized questionnaires. (2005) did an analysis of data from Kohlenberg et al. . CBT or the union of FAP and CBT. while in other countries the presentation of objective data is more frequent. It also demonstrates efforts to increase the effectiveness of other interventions by enhancing them with FAP. In this study the authors apply a FAP intervention adapted to a group of patients with chronic pain. Comparing FAP to other known interventions is an important objective of these publications and is important to the advancement of FAP. this paper suggests the importance of enhancing traditional therapies with FAP.FUNCTIONAL ANALYTIC PSYCHOTHERAPY (FAP): A REVIEW OF PUBLICATIONS 85 Figure 6. Kanter and colleagues found that therapists who used CBT + FAP increased their focus on the therapeutic relationship and this increased focus may have improved weekly outcomes. and Montero (2006) used a pure FAP-based intervention to treat a patient diagnosed with depression. despite having a relatively large number of empirical publications. Note that the same publication may have employed different interventions at different stages of the design and so some publications have indicated more than one intervention. two were systems used to categorize client and therapist behavior (the FIAT and the FAPRS) and the last one was another audiovisual recording system (categorized as systematic observation). For example. Distribution of empirical publications according to the type of design and country of origin of the authors. The distribution of publications suggests that Brazil. (2002) which compared Cognitive Therapy and Cognitive Therapy enhanced by FAP for the treatment of Major Depression. The majority of Brazilian publications have reported on cases treated using FAP but do not present objective measurements. Thirteen empirical studies used systematic observations and some form of recording. Their results showed an increase in CRB2s and a decrease in CRB1s in session. Aguayo. According to the authors. Garcia. Most of the publications described only interventions based on FAP. and 4) Systematic observation of sessions. It appears that most publications on pure FAP involve narrative case studies with no objective data. directly manipulating variables or employing Type III case studies. Kanter et al. This indicates repeated efforts to study FAP through comparison with CBT. Attempts to integrate therapies such as ACT or CBT with FAP appear to have designs with better experimental control. 3) Unsystematic observation of sessions. The final analysis we undertook was of measurement instruments used in FAP publications. Figure 6 presents the different research designs by country of origin of the authors. The best controlled research is that of FAP Enhanced CBT compared to traditional CBT. 2) Categorization systems. Figure 7 shows the distribution of publications by types of interventions performed. has mostly produced narrative case studies. The studies which have not used any form of recording were the narrative single case studies and are mostly Brazilian. such as Mendes and Vandenberghe (2009). explaining in part the finding that Brazil is the only country to produce more empirical than theoretical studies. No objective data is presented or analyzed by the authors. divided among four categories: 1) Scales and standardized questionnaires. a known intervention. signs which offer increased reliability and greater generalization of the data. while the other six studies did not record sessions.

functional nature of the treatment on the one hand. The analysis of measurement instruments used in FAP publications indicates there is no standard for data collection.86 MANGABEIRA. and the desire to produce standardized. This research has progressed from initial descriptions of the process of uncontrolled FAP cases (Busch. suggesting that nomothetic self-report measures will not provide valid measures of FAP processes. are important and viable methods for the necessary standardization to occur for the advancement of research on FAP. interpersonal functioning. 2003) to more sophisticated analyses of controlled single-subject research using A-B designs (Busch. replicable measurement systems on the other hand (Follette & Bonow. A greater number of theoretical studies was found than empirical studies. & DEL PRETTE Figure 7. We believe the use of the research instruments discussed above. KANTER. 2009). Follette at the University of Nevada-Reno. The closest FAP researchers have come to the consistent use of an instrument to create a body of scientific findings is with the use of the FAPRS (Callaghan & Follette. 2008) to measure the turnby-turn therapeutic process in FAP. Follette. ACT (Acceptance and Commitment Therapy). In fact. Tension about how to collect data in FAP exists due to the idiographic. Distribution of publications by types of interventions. Callaghan. and Weidman. and we encourage continued use of the FAPRS and related systems in future research (Follette & Bonow. indicating that much work is necessary to understand FAP as a clinical intervention. it will be easier to conduct the randomized controlled trials of FAP that remain an elusive goal. FAP (Functional Analytic Psychotherapy). some programmatic research using the FAPRS has been conducted at several FAP research sites. Weeks. and additional FAPRS analyses of designs with increased precision and control are now coming out of the University of São Paulo. such as improvements in intimate. as many of the empirical publications are narrative case . Kanter. such as the FIAT and the FAPRS. Jonathan Kanter at his lab at the University of Wisconsin-Milwaukee. Ruckstuhl. it has since been used by Callaghan at San Jose State University. Callaghan. With such validated outcome measures in place. „ FINAL CONSIDERATIONS This survey of publications on FAP between 1990 and 2010 in national and international journals points to a growing number of theoretical and empirical investigations on FAP. BA (Behavioral Activation). Kanter. 2008. The small number of empirical publications is further limited by the small number of publications that present objective data. CBT (Cognitive-Behavioral and Cognitive Therapy). 2010. Baruch. 2009). & Berlin. Also we believe it is important for researchers to develop and validate measurements of hypothesized outcomes in FAP. Summers. 2009). First developed by Callaghan and Follette at the University of Nevada-Reno. and Sonia Beatriz Meyer at her lab at the University of São Paulo. This research highlights the great promise of FAP as not only a behavior analytic clinical intervention but as an intervention that lends itself to sophisticated process research that can feed back and improve the intervention. Callaghan. & Linnerooth. Baruch. the variability of measurement instruments makes it difficult to compare results between studies and to create a body of consistent data on FAP. At the moment. & Weeks. Callaghan. It is highly recommended that future publications focus on the presentation of controlled empirical data to contribute a better analysis of the effectiveness of FAP and the mechanisms that promote change in the therapeutic process in FAP.

A. M... Rusch. J. 98-116. J. Corrigan. P. 19. 11(2). C. Journal of Contemporary Psychotherapy. Psychotherapy: Theory. (1996).. 307-314. M. G. Psychotherapy. A. The integration of psychodynamic and behavior therapies revisited: Approaching rapprochement? Implications for theory and practice. Plummer. The role of emotion in psychotherapy supervision: A contextual behavioral analysis. J. & Callaghan. García R. For example. Callaghan. on several research projects. *Busch. note that these publications are generally the product of the work of clinical psychologists who have close contact with the use of FAP in the therapeutic context.Therapeutic relationship scope and function in behavioral therapy. Journal of Contemporary Psychotherapy.. Getting ahead of the data: A threat to some behavior therapies. E. G. These publications contribute very little to the validation of FAP as an effective intervention in psychotherapy.. In: A guide to Functional Analytic Psychotherapy: Awareness. P. (2010). The clinical utility of client dream reports from a radical behavioral perspective. 21-36). but little dialogue between countries has occurred. & Berlin. The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of clinical effectiveness using Functional Analytic Psychotherapy. G. . Estudos de Psicologia Campinas. D. F. *Callaghan.. 306-312. C.. Baruch. Research. C. Journal of Mental Health. V. 40(3). The development of outcome measures sensitive to the kinds of changes produced by FAP is a necessary research goal. Development of Behavior Therapy with Children and Adolescents. Baruch. provide important directions for future research using designs that offer less threats to the internal validity of the data. There are few researchers who are consistently dedicated to producing research on FAP as indicated by multiple publications. B. J. & Hackbert. V. & Sewell. C. A.. B. International Journal of Behavioral and Consultation Therapy. D. 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