Bere Hinojosa, MDh ⌬⇆⌬

You’re still slipping back into a medicalized way of thinking about psychology. Behavioral science is not primarily about discovering hidden “causes of symptoms” or “healing” people in the medical sense. That language already assumes an underlying disease model. What serious behavioral and contextual approaches focus on instead are functions, contingencies, learning histories, environmental relations and patterns of interaction. The question is not “what hidden thing caused this symptom?” but “under what conditions does this behavior occur, what maintains it, and what variables influence it?” That is a very different epistemological framework from symptom-based explanatory models. So yes, clinicians form hypotheses, but ideally they are functional hypotheses grounded in observable relations and ongoing analysis, not speculative narratives about invisible inner causes. And to be clear, I’m not saying this because I only know behavioral models. I trained in other traditions before moving into behavioral science, and that is precisely why I’m saying this. Many models sound profound because they produce explanations that feel psychologically satisfying, but when you look for precision, functional clarity and reliable mechanisms, they often collapse into interpretation and storytelling rather than solid science.

@berenyz Just wondering how issue of existence of theories that have been tested but of course, as with all scientific theories are still & will always be refined & need to be circumspect . I’m trying to ask: Do we do some work to try to understand what might be causing symptoms?

Un segundo ¿quiere decir que les enseñan ciencia y al final las tecnologías para aplicar? ¡Lléveme a Australia! 😭😭😭

Estudiar a Sidman es entender que el mundo se organiza en redes funcionales. Nuestra labor como clínicos es mapear esas redes para identificar dónde la coerción ha estrechado los repertorios y dónde el refuerzo positivo puede expandirlos.

La equivalencia de estímulos no es un "proceso mental superior"; es una propiedad de las contingencias de reforzamiento. Cuando entrenamos A→B y B→C, la emergencia de C→A es la prueba de que el análisis de la conducta puede explicar la complejidad del lenguaje sin recurrir al dualismo.

You’re getting much closer to the core issue now. No, the problem is not simply that relational approaches are “harder” to define. Human behavior is complex for every model. The difference is that behavioral and contextual traditions forced themselves, philosophically and scientifically, to move toward functional definitions, measurable processes and replicable procedures very early on. Many psychodynamic and relational traditions historically tolerated ambiguity, metaphor, therapist interpretation and broad explanatory narratives for much longer. That produced theories that can sound compelling, but without the level of operational precision needed for rigorous scientific analysis. And that distinction matters enormously. A theory sounding profound, emotionally resonant or clinically intuitive is not the same thing as having a model capable of producing reliable, testable and reproducible intervention. You are also now seeing why university training starts with science rather than “how to be with people.” Clinical intuition without a rigorous framework easily turns into projection, suggestion, confirmation bias and charismatic improvisation. That is exactly what scientific training is meant to prevent. This also explains why many trainings outside universities feel vague. In many cases, the problem is not that you personally failed to understand them. The problem is that the models themselves were never clearly operationalized in a way that allows precise measurement, functional analysis and reliable replication.

@berenyz Some Universities do teach psychodynamic approaches in masters, which I think are evidence based? They are listed as such by Aust. Psychology Society. But unfortunately not my particular uni and only one uni to choose from in my region

Los psicólogos (neuropsicólogos) no usamos bata. Buenos días.

Yes, that’s much closer to the point. A therapy cannot just consist of “meaningful interactions” or therapist intuition. If a model claims to work, it has to specify what is being done, under what conditions, through which mechanisms, and with what expected effects. Otherwise you cannot reliably test it, replicate it, teach it or distinguish it from general supportive interaction. That’s exactly why operationalization matters. A manual alone is not enough. The underlying principles, variables and mechanisms also need to be clearly defined and connected to the intervention procedures. This is where many relational approaches become weaker scientifically. They often describe rich interpersonal dynamics, but the explanatory mechanisms remain broad, interpretive or difficult to isolate precisely. And this is also why behavioral and contextual approaches became scientifically stronger earlier: they forced themselves to define processes functionally and submit them to systematic testing instead of relying mainly on interpretation.

@berenyz So, with relational approaches, there is a need to clearly identify how to carry out the relational intervention. It needs to be clear and it needs to carry across different practitioners. There needs to be a connection between the principles and the methods? Is that right?

Not really. Showing that a TBT-trained therapist gets different outcomes than TAU or another treatment does not automatically validate the theoretical model itself. It only shows that something happened under that treatment condition. The problem is that in highly interpretive approaches like TBT, it becomes difficult to determine what actually produced the change. Was it the specific theory? The therapist’s interpersonal skill? Structure? Attention? Expectancy effects? General therapeutic factors? If the core mechanisms are vague or dependent on subjective interpretation, then outcome comparisons alone are not enough to establish strong explanatory validity. That’s exactly why operational precision matters so much in serious clinical science.

@berenyz If subjective element to a relational approach - eg TBT - am I right to conclude that doesn’t prevent the approach being empirically validated? If what is operationalised is a comparison of treatment by a TBT trained therapist, practicing TBT compared to another treatment or TAU?

Partly, yes. But experimentation alone is not enough. For a relational approach to become scientifically robust, it has to move beyond compelling narratives or subjective impressions and define its variables, mechanisms and procedures clearly enough to be observed, measured and replicated. A lot of approaches remain stuck at the level of interpretation because their concepts are too vague, circular or dependent on the therapist’s personal reading of the interaction. That makes rigorous testing difficult. This is also why behavioral and contextual models advanced more rapidly scientifically: they operationalized processes in observable terms early on and subjected them to systematic analysis. So yes, development requires refinement and experimentation, but it also requires abandoning explanations that cannot be functionally defined or empirically evaluated. That’s the difficult part many approaches never fully achieve.

@berenyz Would I be right to reason that: for relational approaches to get to the point where they were operationally definable enough to be tested properly, people have to experiment with their practice, to get enough understanding of how they think they work to operationalise them?

You’re still reducing evidence-based therapies to a caricature of CBT as “worksheets and thoughts,” when the clinical field is much broader than that. There already are evidence-based interventions for people in extreme states, and many of them do not primarily depend on cognitive effort or “thinking exercises.” ACT, DBT, FAP and ABA, for example, are not based on the classic idea of “changing thoughts to change emotions.” Much of their work involves behavioral contingencies, environmental regulation, exposure, skills training, contextual validation and functional analysis. That’s why it’s important not to collapse every evidence-based approach into “cognitive therapy.” They are not built from the same ontology or explanatory model. And regarding relational approaches, of course they can continue to be developed and researched. But until they are clearly operationalized and supported through rigorous, replicated evidence, they cannot be treated as equivalent to models that already passed that process. In science, sounding meaningful or resonating personally is not enough. A model has to demonstrate consistent and reliable outcomes. The deeper issue is that you still seem to view therapy as something separate from basic science, when in reality many of the tools for working with severe or complex states came directly from decades of rigorous behavioral and contextual research.

@berenyz If there aren’t yet evidenced based methods to work with people in extreme states, who cannot access the mental resources for things s.a CBT etc , then it would be good if they were developed! Relational approaches not already operationalised and tested should be

El reto de los psicólogos: ¡no caer con influencers diagnósticos, los neuro-bestsellers y los coaches de vida!

@DianaJimenez05 Jajaja bededi

@berenyz Se me olvidó su nombre, pero tenía pelo corto y se creía deportista.

Mi anécdota favorita de la carrera es cómo sobreviví a una maestra que creía que los traumas se quitaban presionando huesos.

Un analista de la conducta no necesita ser "inteligente emocionalmente", necesita ser preciso funcionalmente.

@genrigp Algo que me ayudó muchísimo fue entender que la entrevista clínica conductual no es ‘hacer preguntas’, sino discriminar relaciones funcionales en tiempo real. Recomendaría: Sturmey, Froxán, Malott o Clinical Behavior Analysis de Dougher & Hayes

Invoco a los analistas de la conducta en Twitter para que me recomienden alguna bibliografía o recurso que mejore la eficacia con la que hago las entrevistas de evaluación y el correspondiente análisis funcional. Siento que me cuesta mucho trabajo y que puedo mejorarlo bastante.

@DianaJimenez05 Jajajaja ¿quién fue?

@berenyz Bb me pusieron a hacer una rondalla infantil 🫪

@geerothvoss Perdí 5 años de mi vida en sus clases. 😮‍💨

@berenyz Me faltan signos de puntuación para expresar el horror que siento, señora haga lo que quiera en su tiempo libre pero TENGA LA DECENCIA DE NO EXCUSARLO COMO CIENCIA DESDE UNA POSICIÓN DE AUTORIDAD EPISTEMOLÓGICA 😭

Básicamente que tenemos corazas y hay que romperlas (la famosa psicocorporal 😮‍💨) ella en la actualidad es consteladora, trabaja para una universidad y se lleva a los alumnos a hacer rituales con canela. Jura que hace todo por amor a la carrera y que la ciencia es fría.

@geerothvoss Uyyy y no te conté de sus rituales para reencontrarse con su feminidad bebiendo sus fluidos menstruales. (Obliga a los alumnos a ir a sus cursos) pero los alumnos no saben que eso no es psicología y lo andan replicando. 😮‍💨

@berenyz CÓMO SIGUE EJERCIENDO Y ENSEÑANDO ALGUIEN ASÍ!!???!?!?!?

Ni es salud, ni es mental.

@genrigp Jajaja me faltó la materia de lectura de la mente 😂

@berenyz Esto solo se ve en circología 🤣🤣🤣