Applying RFT in therapeutic settings

One of the main challenges clinicians face is working with complex presentations, especially when managing clients who have deeply rooted problems or have intricate and prolonged issues.  These complexities often manifest as:

• Problems with identity and connecting with others,
• A diminished sense of self,
• Longstanding emotional challenges,
• Significant interpersonal difficulties,
• Difficulties in engaging in the therapeutic relationship.

These problems can prove exceptionally challenging to unravel in therapy and can be both time-consuming and emotionally demanding for clinicians. They often require clinicians to adopt precise and concentrated approaches.

Relational frame theory (RFT) is a behavioural account of human language that helps us understand these complexities and provides insights into how we can bring precision to clinical work, thereby increasing the impact and utility of our interventions. An exciting and novel application of RFT in clinical settings is the development of process-based behaviour therapy (PBBT). PBBT offers precise methods to identify the ways in which clients’ life circumstances have led them to become entangled and how this manifests in unhelpful behaviour patterns. This enables practitioners to work with highly complex behaviours and systematically design tailored interventions that facilitate significant changes for the client. The approach allows for a focused and effective therapeutic process.

More about PBBT

Since its inception, process based behaviour therapy (PBBT) has offered clinicians a series of core therapeutic pieces, involving analytic and intervention aids, to understand and change such complex behaviour. It does this in ways that assists practitioners to rapidly identify the key functional issues, to disentangle the knots as efficiently as possible. These pieces evolved organically from broad clinical applications of relational frame theory (RFT). The success of this work has now facilitated the expansion of PBBT into a full therapy regime. What is unique about this development is that PBBT’s analyses, formulations and interventions still sit directly on top of its RFT underpinnings. This makes PBBT the only whole therapeutic programme ever developed that is underpinned entirely by RFT.

Key learning points

During this lecture, you will have the opportunity to hear from Dr. Yvonne Barnes-Holmes, one of the pioneers of PBBT. Yvonne will explore three key areas:

1. An introduction to the therapeutic use of PBBT and explore the tight theoretical connection between PBBT and the updated version of RFT, highlighting its implications for clinical interventions.
2. An exploration into the concept of different “layers” within PBBT and how they manifest in clients. Yvonne will explain the process of identifying these layers and discuss the clinical interventions that PBBT suggests.
3. Lastly, Yvonne will offer valuable insights into what PBBT could look like during therapy sessions, providing a practical understanding of its application.

The lecture will introduce and illustrate all of the key components of PBBT as outlined above. Clinical examples will be used throughout. There will be time for questions and discussion at the end.

Who is this workshop for?

This workshop is for clinicians, practitioners, BCBAs, UKBA (Cert)s, and therapists who work therapeutically with clients and who want to deepen their understanding of the clinical applications of RFT.