FAP and ACT

What is functional analytic psychotherapy (FAP)?

Functional analytic psychotherapy (FAP) is a therapeutic approach rooted in behaviourism and contextual psychology, specifically in the principles of Skinnerian behaviour analysis. It focuses on using the therapeutic relationship as a central means to promote meaningful and lasting behavioural change in clients.

What are the core principles of FAP?

There are many aspects to FAP but they can be broken down into these core principles:

• Therapeutic relationship as a change agent: FAP views she relationship between the therapist and the client is central to the approach. The approach assumes that the way clients behave in therapy mirrors how they behave in their daily lives. The therapist uses this relationship to model and reinforce healthier behaviours.
• Clinically relevant behaviours (CRBs): FAP identifies and works with three types of client behaviours:
  • CRB1: Problematic behaviours that occur during therapy (e.g., avoidance, withdrawal).
  • CRB2: Improved or adaptive behaviours—a sign of progress (e.g., assertiveness, openness).
  • CRB3: Client learning to analyse their own behaviours (e.g., self-awareness and insight).
• Reinforcement in the present moment: FAP emphasises observing client behaviours in real-time during therapy sessions and providing immediate reinforcement or feedback to encourage positive change.
• Awareness and emotional connection: Therapists build a deep, authentic connection with their clients, creating a safe space for vulnerability. This connection allows clients to explore and change maladaptive patterns.
• Generalisation to daily life: The ultimate goal is for clients to take the insights and improved behaviours developed in therapy and apply them to their relationships and interactions outside of therapy.

How FAP works

• Observing behaviour in the session: The therapist pays close attention to how the client interacts, noticing patterns that may arise in their relationships outside therapy.
• Shaping behaviour: By reinforcing positive behaviours and gently addressing problematic ones, the therapist helps the client learn healthier ways of interacting.
• Encouraging awareness: The therapist works with the client to help them recognise their own behaviour patterns as they occur in session and understand how these impact their relationships.
• Promoting vulnerability: Therapists are encouraged to be emotionally present and authentic, modelling openness and trust.

Who can benefit from FAP?

FAP is particularly effective for clients struggling with interpersonal and emotional challenges because it focuses on real-time behaviours in therapy, using the therapeutic relationship to address and transform these patterns. Here are some examples of how FAP can be beneficial for some of the most common issues:

Relationship Issues:

Clients often bring difficulties in relationships to therapy, such as conflict, difficulty maintaining close connections, or patterns of unhealthy dynamics. FAP is uniquely suited to address these because:

• It views the therapy session as a microcosm of the client’s relationships. The way clients interact with the therapist often mirrors how they interact with others in their lives.
• The therapist can provide immediate feedback, helping clients recognise unhelpful patterns, like being overly critical, withdrawing, or being overly accommodating, and practice healthier ways of relating.
• By creating a safe, genuine, and supportive relationship in therapy, FAP helps clients develop secure attachment behaviours that they can generalise to other relationships.

Emotional avoidance:

Emotional avoidance is a common issue where clients struggle to confront, express, or process their feelings. This can lead to problems like suppressed emotions, anxiety, or difficulties connecting with others. FAP addresses this by:

• Encouraging clients to stay present with their emotions during therapy sessions and explore them in a safe environment.
• Using the therapist’s authentic and emotionally attuned responses to model how to navigate vulnerability and emotional expression.
• Reinforcing behaviours where the client acknowledges, expresses, or shares their emotions, helping them build emotional resilience and openness.

Social anxiety or isolation:

Social anxiety often stems from fear of negative judgment, rejection, or discomfort in social interactions. This can lead to avoidance of relationships, loneliness, and isolation. FAP is effective because:

• Clients’ social behaviours (e.g., avoiding eye contact, hesitating to share, or over-apologising) often emerge in therapy, allowing the therapist to address these behaviours in real time.
• The therapist provides nonjudgmental feedback, reinforcing behaviours like speaking openly, expressing needs, or maintaining assertiveness.
• Over time, clients learn that vulnerability and authenticity are met with acceptance in therapy, which can help them build confidence in social situations outside of therapy.

Maladaptive interpersonal patterns:

Maladaptive interpersonal patterns, such as being overly controlling, dependent, or passive, often stem from unhelpful learned behaviours or unmet emotional needs. These patterns can alienate others or perpetuate dysfunctional dynamics. FAP helps by:

• Creating an environment where these patterns naturally arise in the therapeutic relationship, allowing the therapist to directly observe and address them.
• Helping clients identify the underlying motivations for these behaviours (e.g., fear of abandonment, need for approval) through functional analysis.
• Reinforcing alternative, healthier behaviours in the moment, such as expressing needs clearly, setting boundaries, or tolerating discomfort in relationships.

Chronic feelings of disconnection:

Clients who feel chronically disconnected from others often struggle with intimacy, trust, and vulnerability. These feelings may stem from past trauma, neglect, or difficulty forming meaningful relationships. FAP is particularly effective because:

• The authentic and emotionally attuned relationship between the therapist and client serves as a model for healthy connection.
• Clients are encouraged to take interpersonal risks in session, such as being vulnerable, sharing personal thoughts, or expressing gratitude. The therapist reinforces these behaviours, helping clients build a sense of safety in connection.
• Over time, clients learn to trust the process of forming relationships, reducing feelings of isolation and fostering deeper connections in their personal lives.

These challenges often involve patterns that are difficult for clients to recognise or change on their own. FAP’s focus on real-time feedback, emotional authenticity, and relationship-based learning makes it uniquely suited to address these struggles. By working on these issues during therapy sessions, clients gain tools and confidence to transform their emotional and relational lives outside of therapy.

Key techniques used in FAP

Functional analytic psychotherapy creates a dynamic and interactive therapeutic process that nurtures self-awareness, emotional growth, and meaningful change.

Techniques such as evocation, feedback, reinforcement, functional analysis, and generalisation are essential components of FAP. Here we explore each of them in some more detail:

Evocation:

Evocation involves encouraging clients to express their feelings, thoughts, and behaviours openly during therapy sessions. The therapist gently invites the client to bring their inner experiences into the session, especially those that might feel difficult, vulnerable, or uncomfortable. This technique is central to FAP because it allows the therapist to observe and address the client’s “clinically relevant behaviours” (CRBs) in real-time. By eliciting genuine emotional and behavioural responses, the therapist creates opportunities for the client to practice new, healthier ways of interacting. This process deepens the therapeutic relationship and helps the client engage more authentically in their own life.

Feedback:

Offering immediate, compassionate feedback can help clients understand how their actions affect others. Feedback is offered in the moment when the client’s behaviour aligns with (or deviates from) their therapeutic goals. For instance, if a client hesitates to speak up about their needs, the therapist might say, “I noticed you paused when you were about to tell me what you wanted. Can we explore what’s happening there?”. This real-time feedback helps clients build awareness of their habits and tendencies, particularly those that may be contributing to problems in their relationships. Compassionate feedback also models how to give and receive constructive input, which clients can apply in their own interactions.

Reinforcement:

This is used to encourage and strengthen adaptive behaviours that the client demonstrates during therapy. For example, when a client engages in a desired behaviour, such as expressing vulnerability, setting a boundary, or demonstrating assertiveness, the therapist responds in a way that reinforces it so they may show appreciation, offer verbal praise, or acknowledge the client’s courage and effort. By directly experiencing the benefits of adaptive actions, clients build confidence and motivation for change. It’s worth noting that reinforcement is neither mechanical nor manipulative—it is a deeply genuine and compassionate process. The aim is to authentically acknowledge and highlight the positive impact of a client’s new, often challenging behaviour. By doing so, the therapist helps the client see the meaningful consequences of their actions, fostering courage and growth. This approach is rooted in care and collaboration, supporting the client in moving towards behaviours that align with their values and lead to a richer, more fulfilling life.

Functional analysis:

This technique helps to uncover the underlying motivations, triggers, and reinforcers that maintain problematic behaviours. The therapist and client collaboratively examine a specific behaviour that occurs during therapy (e.g., a client shutting down emotionally). They explore questions such as: What led to this behaviour? What purpose does it serve? What are the results of behaving this way? This process helps identify patterns and create opportunities for change. By understanding the function of maladaptive patterns, clients can work toward replacing them with more constructive alternatives.

Generalisation:

this is the process of assisting clients to transfer the skills they learn in therapy to their everyday lives. The therapist and client work together to identify real-life situations where new behaviours can be applied. For example, if a client learns to assert themselves in therapy, they might practice doing so with a spouse, friend, or coworker. The therapist might assign homework or role-play scenarios to prepare the client for these situations.

How can FAP be integrated with ACT?

FAP is often integrated with therapeutic approaches such as ACT (acceptance and commitment therapy) and CBT (cognitive behavioural therapy) to address a variety of psychological challenges. What makes FAP unique is its focus on the therapeutic relationship as a dynamic, in-the-moment context for change.

Both FAP and ACT share foundational principles, such as a focus on mindfulness, the therapeutic relationship, and the importance of behaviour change. When integrated, they can create a powerful synergy to address clients’ challenges by combining ACT’s structured framework with FAP’s relational focus. Here are some examples or how they can work together:

• Shared philosophical foundations: FAP and ACT are both grounded in relational frame theory (RFT), a behavioural account of human language and cognition. This shared foundation allows the therapies to complement each other seamlessly:
  • Focus on context: Both approaches emphasise understanding behaviour in the context of a person’s life, rather than labelling behaviours as inherently good or bad.
  • Present-moment awareness: Both FAP and ACT focus on living in the present moment, whether through mindfulness (ACT) or the therapeutic interaction (FAP).
  • Behavioural change: Both aim to help clients change behaviours that interfere with their well-being while fostering more adaptive, values-driven actions.
• FAP enhances ACT’s relational component: While ACT provides a strong framework for helping clients accept difficult emotions and commit to value-driven behaviour, it does not explicitly focus on the therapeutic relationship as a tool for change. FAP fills this gap by:
  • Leveraging the relationship: FAP uses the therapist-client relationship as a microcosm of the client’s broader relational patterns. This allows the therapist to provide real-time feedback and reinforcement, helping clients practice interpersonal skills in a safe environment.
  • Deepening emotional connection: ACT encourages clients to explore their emotional experiences, but FAP brings these emotions into the therapeutic relationship. For example, a client learning to accept vulnerability through ACT principles can practice being vulnerable with the therapist in FAP.
  • Addressing interpersonal behaviours: ACT encourages value-driven action, but FAP focuses on identifying and changing maladaptive relational patterns (e.g., avoidance, withdrawal). These patterns often emerge in the therapeutic relationship, providing an opportunity for real-time intervention.
• ACT provides a structured framework for FAP: While FAP focuses on moment-to-moment interactions and behaviours within the therapy session, ACT provides a broader, more structured framework for understanding and addressing clients’ struggles:
  • Values clarification: ACT helps clients identify their core values, which can guide their behavioural goals in therapy. FAP therapists can then use these values to shape interactions and reinforce behaviours aligned with the client’s goals.
  • Psychological flexibility: ACT targets six core processes (e.g., acceptance, cognitive defusion, mindfulness, values, committed action, and self-as-context) to help clients become more flexible in their thinking and actions. FAP can reinforce these processes by encouraging clients to practice them in-session, particularly in relational contexts.
  • Commitment to change: ACT encourages clients to take committed action toward their values. FAP can support this by reinforcing value-driven behaviours as they occur in therapy and helping clients generalise these behaviours to their daily lives.
• Complementary focus: Internal and external change
  • ACT focus: ACT often focuses on internal processes such as accepting emotions, defusing from unhelpful thoughts, and clarifying values. It helps clients build psychological flexibility and tolerate discomfort in the service of meaningful action.
  • FAP focus: FAP focuses on external behaviours, particularly in relationships. It uses the therapeutic relationship to model and reinforce healthy interpersonal behaviours.
  • How they work together: In practice, ACT helps clients build the internal awareness and acceptance needed to face challenges, while FAP helps clients translate these insights into real-world relational and behavioural change.

Synergy in generalisation

Both therapies emphasise generalisation, ensuring that what clients learn in therapy applies to their daily lives. In ACT, clients are encouraged to engage in value-driven actions outside of therapy, despite discomfort. In FAP, clients practice interpersonal behaviours in-session and receive real-time feedback, making it easier to generalise these skills to their relationships outside of therapy. When combined, FAP and ACT provide a comprehensive approach to therapy. ACT offers a structured framework for building psychological flexibility and aligning actions with values, while FAP deepens and personalises the work by addressing relational patterns through the therapeutic relationship.

 

Foundational Texts

Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: A guide for creating intense and curative therapeutic relationships. Plenum.

Tsai, M., Kohlenberg, R. J., Kanter, J. W., Kohlenberg, B., Follette, W., & Callaghan, G. (2009). A guide to functional analytic psychotherapy: Awareness, courage, love, and behaviorism. Springer.

 

Empirical Research & Mechanisms of Change

Callaghan, G. M. (2006). The Functional Idiographic Assessment Template (FIAT) System: For use with interpersonally-based interventions including Functional Analytic Psychotherapy (FAP) and FAP-enhanced treatments. The Behavior Analyst Today, 7(2), 357–398.

Tsai, M., Yard, S., & Kohlenberg, R. J. (2014). Functional Analytic Psychotherapy: A behavioral relational approach to treatment. Psychotherapy, 51(3), 364–371.

Kanter, J. W., Holman, G., & Wilson, K. G. (2014). Where is the love? Contextual behavioral science and behavior analysis. Journal of Contextual Behavioral Science, 3(2), 69–73.

 

Clinical Applications & Effectiveness

Holman, G., Kanter, J. W., Tsai, M., & Kohlenberg, R. J. (2017). Functional Analytic Psychotherapy made simple: A practical guide to therapeutic relationships. New Harbinger.

Mangabeira, V., Kanter, J. W., & Del Prette, G. (2012). Functional Analytic Psychotherapy (FAP): A review of publications from 1990 to 2010. International Journal of Behavioral Consultation and Therapy, 7(2–3), 78–89.

 

FAP and Specific Populations

Callaghan, G. M., Summers, C. J., & Weidman, M. (2003). The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of Functional Analytic Psychotherapy’s effectiveness. Journal of Contemporary Psychotherapy, 33(4), 321–339.

Skinta, M. D., Lezama, M., Wells, G., & Dilley, J. W. (2017). Acceptance and compassion-based group therapy to reduce HIV stigma. Cognitive and Behavioral Practice, 24(1), 11–25.

Maitland, D. W., & Gaynor, S. T. (2016). Functional Analytic Psychotherapy for interpersonal processes in depression: A multiple baseline examination of treatment effects. Psychotherapy Research, 26(2), 140–151.