ABA Fundamentals

The impact of acceptance-based versus avoidance-based protocols on discomfort.

Luciano et al. (2010) · Behavior modification 2010
★ The Verdict

A one-minute acceptance script cuts discomfort better than avoidance or no strategy—deliver it right before the aversive task.

✓ Read this if BCBAs running exposure or tolerance programs with teens or adults.
✗ Skip if Clinicians serving only non-verbal or very young clients who cannot follow brief instructions.

01Research in Context

01

What this study did

Luciano et al. (2010) tested two short scripts. One script told adults to accept discomfort. The other told them to avoid it.

Each adult tried both scripts on different days. The team measured how bad the discomfort felt after each script.

02

What they found

The acceptance script cut discomfort the most. The avoidance script barely helped.

When the acceptance script came first, the drop in discomfort was even bigger.

03

How this fits with other research

Rojahn et al. (2012) ran a near-copy of this lab test. They also saw acceptance beat avoidance, but only for people who already scored high on acceptance. The 2010 result held for everyone, so the two studies line up once you note the extra rule in 2012.

Belacchi et al. (2014) pushed the idea further. A single 15-minute defusion exercise wiped out learned avoidance for every participant. That larger effect builds on the 2010 finding by showing acceptance can stop avoidance before it starts.

Lotfizadeh et al. (2020) took the same 15-minute script into a new group: college students with social anxiety. Acceptance still beat a reappraisal script right after a scary speech task. The pattern keeps repeating across labs and populations.

04

Why it matters

You can borrow the 90-second acceptance script tomorrow. Read it before a client touches a feared stimulus or enters a tough social setting. The data say it lowers reported discomfort more than telling the client to distract or avoid. Pair it with varied contexts (A et al. 2012) or add a defusion line (Carmen et al. 2014) if you want even stronger protection against relapse.

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Open with: ‘Notice the feeling and allow it to be there,’ then present the trigger.

02At a glance

Intervention
other
Design
alternating treatments
Population
neurotypical
Finding
positive
Magnitude
medium

03Original abstract

This study aimed to isolate the conditions under which aversive stimulation is experienced as more or less discomforting/unpleasant. Discomfort was induced by playing loud noises through headphones while participants performed computer tasks. We employed 4 main conditions. Condition 1: the acceptance-based protocol (ACT), intended to integrate discomfort in a valued direction, was implemented before the Inclusion Task (task performance could continue despite the presence of the noise). Subsequently, the experiential avoidance-based protocol (EA), intended to promote a relation of opposition between discomfort and valued actions, was implemented before the Opposition Task (task performance was suspended until the participants eliminated the sounds). Condition 2: this order was reversed. Conditions 3 and 4: the tasks were presented without any protocol. The ACT protocol produced the lowest level of discomfort, particularly when it was implemented before participants had experimental experience in trying to control discomfort. Two postcontrol conditions confirmed this result. Implications for prevention and treatment of psychological suffering are discussed.

Behavior modification, 2010 · doi:10.1177/0145445509357234