Clinical Behavior Analysis (CBA) & Acceptance and Commitment Therapy (ACT)

About My Approach

Clinical behavior analysis (CBA) is a subspecialty of contextual behavior science that involves examining how behavior serves someone and is maintained by its context, followed by using this information to create effective interventions for improving people’s lives. Oftentimes, this involves methodologies such as acceptance and commitment therapy (ACT). One of the primary clinical outcomes in ACT is to increase our psychological flexibility, which is the ability to contact the present moment more fully, as it is, not as our mind judges it to be, and based on what the situation affords, to persist or change in behavior in the service of what matters to you.

Acceptance and Commitment Therapy (ACT) is a transdiagnostic model designed to increase psychological flexibility rather than to target any single diagnosis. Though, increases in psychological flexibility have been shown to decrease symptomatology for a wide range of concerns, including anxiety, depression, trauma, chronic pain, stress, relationship difficulties, ADHD, autism, and more, and is additionally associated with an increase in quality of life measures.

With greater psychological flexibility, you can experience thoughts and feelings without being dominated by them, make clearer choices aligned with your values, and engage in meaningful action despite challenges that present themselves. Through ACT, we approach developing psychological flexibility through six main processes: Acceptance, Defusion, Present Moment Awareness, Self-as-Context/Flexible Self, Committed Action, and Values. These processes can be categorized into 3 overarching processes: Open, Aware, and Engaged.

Open

This is the process of making room for difficult internal experiences (thoughts, emotions, memories, urges) without getting trapped by them. We work together to learn skills to reduce the power these factors can have over us. This involves acceptance work, which includes learning how to allow these experiences to exist within us, as well as defusion work, learning how to reduce the control they have on your covert behavior (thoughts, attention) and overt behavior (actions).

Aware

This is the process of developing flexible contact with the present moment, both internally (within your mind and body) as well as externally (with your 5 senses). This work helps us notice what’s happening inside and around us so we can respond more flexibly instead of reacting on autopilot. Building this capacity reduces reactivity and opens up choices that are otherwise hidden when we’re overwhelmed or trapped inside our minds.

Engaged

This is the process of taking sustained, values-guided action. This includes identifying what truly matters to you and how you want to show up in your life and translating that information into achievable steps. Engagement is not about perfection; it’s about small, consistent actions that move you toward a life you care about, even when discomfort is present. We’ll work in this area by creating realistic goals, troubleshooting barriers, and learning skills that support resilience.

How this Looks in Therapy

  • We’ll explore the specific challenges you’re facing, such as feelings of depression, anxiety, stress, relationship struggles, substance use, chronic pain, sleep problems, attention or impulse difficulties, or parenting and behavioral challenges, and we’ll look at how this shows up in your context: what tends to come before it, what follows it, and how that pattern has stayed in place. This can also involve exploring where these patterns came from originally. From there we explore evidence-based strategies to help you build the life you want in the face of these challenges.

  • We’ll practice exercises together in session and identify where they’re most useful for you in your life. You’ll be encouraged to practice these exercises in those relevant contexts between sessions as experiments.

  • We’ll explore how you want to show up in your life. We’ll work on gaining clarity on what actually matters to you, rather than what others have might have told you matters to you.

  • Over the course of working together, you’ll develop strategies to use throughout your day to reduce the power that difficult thoughts, feelings, urges, memories, and sensations have over your life. ACT and CBA are helpful for people learning many types of skills, including: social communication and relationship skills, emotion regulation and distress-tolerance, time management and executive functioning skills, habit change and self-care routines, and interpersonal conflict resolution skills.