功能分析心理疗法（functional analytic psychotherapy, FAP）是一种聚焦人际关系问题的情境疗法,强调治疗情境与日常环境的功能等同性,重视强化的作用和治疗关系的发展。在ACL模型（即awareness意识、courage勇气、love爱）的指导下,FAP基于5项治疗准则开展治疗,识别、解释和促进临床相关行为的改变,并采用多种工具检验治疗效果、评估治疗师的能力、了解来访者的心理特征和治疗变化。FAP在人际关系问题中的治疗效果得到团体和个案研究的证明,并在治疗神经症和其他人格障碍中取得重要进展。但已有研究仍存在设计缺陷、内在机制和治疗效果探讨不足等问题,且FAP尚未引起国内学者的关注。未来应完善研究方法与设计,探讨内在作用机制和脑生理基础,推进国内实践和研究以及线上治疗服务。
Abstract
Humans are inherently social beings. Interpersonal communication is a fundamental human need. The quality of interpersonal relationships plays a crucial role in predicting and influencing mental health outcomes. A strong interpersonal bond not only signifies good mental well-being but also acts as a protective factor. Interpersonal relationship problem is an important manifestation of many mental disorders, making them an integral aspect of mental health problems.
The Functional Analysis Psychotherapy (FAP) is a contextual behavioral psychotherapy that focuses on interpersonal relationships. It is part of the “third-wave” cognitive-behavioral therapies that emphasize mindfulness, acceptance, emotions, relationships, values, and meta-cognition, and is designed to help clients clarify their values and encourage them to take positive and flexible actions to change their lives. Proposed by Kohlenberg and Tsai in 1991, FAP is often described as “process-based”. It emphasizes the functional equivalence between the therapeutic condition and the daily environment, as well as to value the role of reinforcement (especially natural reinforcement, that is an immediate, spontaneous reinforcement) and relationship development during and outside of treatment. The FAP approach emphasizes the significance of clients’ words and actions in therapy, enabling therapists and clients to establish a meaningful therapeutic relationship through analyzing behavior. It focuses on clinically relevant behaviors (CRBs) related to what clients say and do, including clinically relevant behaviors in daily life (CRB1s), improvements in behaviors (CRB2s), and their explanations for their behaviors and the reasons for their behaviors (CRB3s), as demonstrated by the client's during therapy. The ultimate goal is to restore the client’s social adaptive functioning. It is based on five treatment guidelines for identifying, evoking, reinforcing, explaining, and promoting clinically relevant behavior changes under the guidance of the ACL model which includes awareness, courage, and love. In fact, the ACL model describes a binary interaction process between clients and therapists to assess problems and treatment goals achievement. FAP utilizes the Functional Analytic Psychotherapy Rating Scale (FAPRS), the Functional Analytic Psychotherapy Competency Scale (FAPCS), and the Functional Analytic Psychotherapy Intimacy Scale (FAPIS) to assess the treatment effectiveness, therapist competency and gain insight into clients’ psychological characteristics and changes throughout the treatment process.
Originally used to treat individuals with interpersonal relationship disorders, FAP’s effectiveness in improving such conditions has been extensively demonstrated through group studies and case analyses. The treatment effectively reduces maladaptive behavior while promoting adaptive behavior, leading to improved interpersonal communication. Additionally, it has made significant progress in treating depression and various personality disorders like schizophrenia, borderline personality disorder, antisocial personality disorder. The FAP treatment framework and method can be used alone or integrated into other treatments such as the Functional Analytic Psychotherapy and Acceptance and the Commitment Therapy (FACT) to enhance therapeutic effects, and Functional Analytic Psychotherapy enhanced Behavioral Activation (FEBA), a short-term structured treatment for depression.
Actually, FAP has developed into a relatively complete treatment mode, with clinical studies demonstrating its wide-ranging value and clinical significance. However, the existing studies still suffer from issues such as defective experimental design, inadequate exploration of intrinsic mechanisms and treatment effects. Moreover, FAP, as a novel and promising therapeutic method, has not yet garnered full attention and application from domestic scholars. Follow-up studies should improve the research methods and design of FAP, explore the treatment principles of FAP and the neurological changes of patients, and promote the localization of FAP along with the application of online treatment services.
Psychological counseling and therapy is crucial to help individuals maintain their mental abilities for social adaptation, and to promote the establishment of a comprehensive social psychological service system through the development of mental health services. Therefore, by introducing FAP and exploring its feasibility for future research, we believe that domestic psychological treatment methods can be enriched, the system of psychological counseling and treatment theory can be further improved, thereby providing valuable reference and guidance for counselors and therapists.
关键词
功能分析心理疗法 /
人际关系障碍 /
功能等同性 /
心理治疗 /
“第三浪潮”认知行为疗法
Key words
functional analysis psychotherapy /
interpersonal relationship disorder /
functional equivalence /
psychological therapy /
“third wave” /
cognitive and behavioral therapy
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基金
*本研究得到安徽省高等学校人文社会科学研究重大项目（SK2021ZD0020）的资助
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