CFQ-7 — Cognitive Fusion Questionnaire

The CFQ-7 measures cognitive fusion: the tendency to become entangled with thoughts and treat them as literal truth rather than as mental events. It’s the companion process measure to the AAQ-II, and the one that speaks most directly to defusion work.

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What it measures

How much the client is fused with their thinking — struggling with thoughts, over-analyzing, getting upset at themselves for having certain thoughts, unable to let go of an upsetting one even when they can see that letting go would help. Seven items, each rated on a seven-point true-for-me scale. Higher scores mean more fusion, which means worse functioning. The 7-item form is the recommended final version. A 13-item version was developed in the same 2014 paper; the CFQ-7 is the one that carried forward.

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When to use it

• Baseline before defusion work. If the treatment plan includes defusion exercises, this is the number they’re aimed at.
• Every 4–6 weeks through an ACT protocol. Same cadence as the AAQ-II, and usually administered with it.
• When rumination or over-analysis is the presenting pattern. Item 3 (“I over-analyze situations to the point where it’s unhelpful to me”) and item 6 (“I tend to get very entangled in my thoughts”) are often the ones a client recognizes themselves in.
• Alongside a thought record when you’re deciding between restructuring and defusion. A high CFQ-7 suggests the client is treating thoughts as facts — which is an argument for changing the client’s relationship to the thought rather than arguing with its content.

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How clients fill it

Under two minutes. The stem is the same one the AAQ-II uses: “Below you will find a list of statements. Please rate how true each statement is for you. Use the scale below to make your choice. 1 = Never true, 2 = Very seldom true, 3 = Seldom true, 4 = Sometimes true, 5 = Frequently true, 6 = Almost always true, 7 = Always true.” All seven items share the same seven options:

• Never true
• Very seldom true
• Seldom true
• Sometimes true
• Frequently true
• Almost always true
• Always true

Because the scale matches the AAQ-II exactly, clients filling both back-to-back move through them quickly.

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How Rivet scores it

Never true scores 1 through to Always true at 7, with the intermediate options running 2 through 6 in order. The total is the sum of all seven items. Range: 7–49. No reverse-scored items, no subscales — a single total. Higher means more fusion.

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Score bands

The CFQ-7 has no strict diagnostic cutoff. 28 is the commonly used elevated threshold, and it’s there because it works out to a per-item average of 4 — the client is at “Sometimes true” or above across the board. Treat it as an interpretive marker, not a decision rule.

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Clinical change

No minimal clinically important difference is published for the CFQ-7 in the source Rivet scores it from. As with the AAQ-II, the useful read is movement across a band boundary alongside whatever symptom measure you’re tracking. Rivet shows the current total only.

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Using it in a Canadian practice

Your client’s answers stay in Canada. A completed CFQ-7 is health information about a named person. The answers are stored encrypted in a Montreal data centre and land in that client’s chart against the session they belong to. Nothing goes to an outside service to be scored. Getting it into your file of record. The scored result copies out formatted for a progress note, so it pastes into Jane, Owl or whatever holds the record. You’re not retyping a total, and the interpretation travels with it. English only. The version here is English. If you practise in French, you’ll be working from your own copy for that client.

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When NOT to use it

• As a diagnostic instrument. Fusion is a process, not a disorder.
• Outside a model that works with the client’s relationship to their thoughts. In a purely behavioural course of treatment, the number doesn’t connect to anything you’re doing.
• As a substitute for the AAQ-II. They correlate but they aren’t interchangeable. Fusion and experiential avoidance are separable, and the treatment implication differs — defusion work for one, willingness and exposure work for the other.

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CFQ-7 vs AAQ-II

Same length, same direction, different process. The CFQ-7 is about cognitive fusion — treating a thought as a fact. The AAQ-II is about psychological inflexibility more broadly, including the avoidance behaviour that follows from it. That makes the CFQ-7 the sharper instrument when defusion is the active piece of work, because it measures the thing you are directly trying to change. The AAQ-II is the broader read, and the one more people will recognise. One caveat on the threshold: the 28 mark is a practical convention for “elevated”, not a validated diagnostic cutoff. There isn’t one in the literature, and the score is better read as a trend across sessions than as a line the client is on one side of.

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Is it free to use?

Yes. Free clinical and research use, per the Association for Contextual Behavioral Science.

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Citation

Gillanders, Bolderston, Bond, Dempster, Flaxman, Campbell, Kerr, Tansey, Noel, Ferenbach, Masley, Roach, Lloyd, May, Clarke & Remington (2014). Behavior Therapy, 45: 83–101. Free for clinical and research use, per its ContextualScience distribution. Rivet preserves the canonical item wording verbatim.

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