Acceptance and Commitment: Implications
for Prevention Science
Steven C. Hayes
Published online: 9 August 2008
Society for Prevention Research 2008
Abstract Recent research in behavior analysis and clinical
psychology points to the importance of language processes
having to do with the control of negative cognition and
emotion and the commitment to valued action. Efforts to
control unwanted thoughts and feelings, also referred to as
experiential avoidance (EA), appear to be associated with a
diverse array of psychological and behavioral difficulties.
Recent research shows that interventions that reduce EA
and help people to identify and commit to the pursuit of
valued directions are beneficial for ameliorating diverse
problems in living. These developments have the potential
to improve the efficacy of many preventive interventions.
This paper reviews the basic findings in these areas and
points to some ways in which these developments could
enhance the impact of preventive interventions.
Behavior analysis and clinical and social psychology have
been fruitful sources of preventive intervention develop-
ment over the last 30 years. Reinforcement techniques that
behavior analysts first clarified (e.g., Kazdin 1978) are now
used in most empirically supported preventive interventions
(Biglan 2003). Classroom-based curriculum interventions
employ techniques from social psychology and behavior
therapy (e.g., Evans et al. 1977). Refusal-skills training
evolved from clinical research on social skills training (e.g.,
Glaser et al. 1983). Other successful preventive interven-
tions are direct adaptations of clinical interventions.
Examples include divorce adjustment counseling (Sandler
et al. 1986) and parenting skills interventions (e.g.,
Andrews et al. 1993). However, some important recent
developments in these fields do not appear to have
penetrated the field of prevention science.
Over the past 10 years, considerable empirical evidence
has accumulated to indicate that humans tend to avoid
unpleasant thoughts and feelings and that doing so
contributes to a wide range of psychological and behavioral
problems. This inclination to avoid unpleasant thoughts and
feelings has been labeled experiential avoidance (EA).
Clinical interventions that reduce EA by fostering accep-
tance of unpleasant thoughts and feelings and commitment
to valued actions have proven effective in reducing a wide
range of problems. The evidence points to a need for
research on whether reducing EA could prevent many other
psychological and behavioral problems.
We first review correlational evidence regarding EA. We
then describe Acceptance and Commitment Therapy
(ACT), a systematic approach to reducing EA, and then
review evidence that this clinical intervention can affect
diverse psychological and behavioral problems. Finally, we
suggest how to extend this line of work to the prevention of
a wide variety of problems.
Growing evidence suggests that EA is an important risk
factor in development of internalizing problems, substance
abuse, and possibly externalizing problems. EA is the
Prev Sci (2008) 9:139–152
A. Biglan (*)
Oregon Research Institute,
1715 Franklin Boulevard,
Eugene, OR 97403, USA
S. C. Hayes
University of Nevada Reno,
Reno, OR, USA