Researching and Remediating Adolescents’ Rigid Rule-Governed Behavior

The relational frame theory (RFT) account of rule-governed behavior (RGB) outlines theoretically distinct types of rule-following. One of these types, namely pliance, is conceptualized as rule-following controlled by apparent arbitrary (i.e., non-natural), speaker-mediated consequences and is theorized to be particularly problematic for young people once generalized. The current research program (i) further explored extant self-report measures of adolescents’ generalized pliance (Manuscripts 1 and 2), (ii) outlined the broader clinical and societal relevance of the RFT account of RGB (Manuscripts 3, 4, and 5), and (iii) explored the impact of acceptance and commitment therapy (ACT) on adolescents’ rigid RGB (Manuscripts 4 and 5). Employing survey designs, Manuscripts 1 and 2 examined the Generalized Pliance Questionnaire-Children (GPQ-C). Both studies supported the use of the GPQ-C with adolescents. Manuscript 1 further highlighted that pliance can simultaneously be associated with measures of adaptive and maladaptive functioning. Manuscript 2 highlighted that (i) females in the Irish context report higher generalized pliance than males, and (ii) gender differences in generalized pliance in the Colombian context may correct themselves during adolescence. Manuscript 3 outlined the broader clinical and societal relevance of the RFT account of RGB with reference to the coronavirus pandemic. Manuscript 4 was a three-arm parallel-group pilot randomized controlled trial (RCT) that (i) evaluated universal chatbot-delivered ACT for adolescents’ rigid RGB, and (ii) assessed the feasibility of using high temporal density measures of problematic rule-following. No statistically significant changes in any dependent variable were observed across conditions or over time. Chatbot-delivered ACT demonstrated adequate acceptability. Nesting ecological momentary assessments in the chatbot was deemed highly feasible. Manuscript 5 was a single-case A-B design with high temporal density assessments that examined the impact of a ten-session group-based ACT intervention on adolescents’ distress, psychological inflexibility, cognitive fusion, generalized pliance, and perceived ply workability. Hypotheses for the standardized questionnaires (i.e., predicted decreases) were partially supported (only avoidance and fusion ratings decreased from pre- to postintervention). Ecological momentary assessment data provided moderate support for the ACT intervention; daily avoidance and pliance ratings significantly decreased across time for most participants. Findings regarding perceived ply workability were less consistent (i.e., although ply workability ratings significantly decreased for 3/6 participants, the overall effect was not statistically significant). Taken together, the present collection of manuscripts forms a coherent research program that makes a substantial and original contribution to knowledge of rigid RGB, giving rise to active discussions and research in the field. Findings have implications for interventionists, researchers, and other professionals. For example, although chatbot-delivered ACT demonstrated adequate acceptability, interventions may need to last longer than one hour in duration and span longer than five days to occasion detectable changes in dependent variables. In addition, given that the single-item assessments of avoidance and problematic RGB performed well (i.e., relatively stable baselines, some replicated shifts across individuals, etc.), professionals may wish to trial using those single-items with clients/participants going forward. Research program limitations (e.g., the use of middle-level terms) and directions for future research are discussed (e.g., addressing apparent conceptual inconsistencies in the RFT account of RGB).