What is the Cognitive Fusion Questionnaire (CFQ)?
The Cognitive Fusion Questionnaire (CFQ) is a standardized, 7-item psychometric assessment used by mental health professionals to measure how deeply an individual is entangled with their own thoughts.
The CFQ is designed as a brief, accessible self-report measure. It presents the respondent with seven statements that reflect common experiences of being stuck in, or controlled by, one’s inner dialogue (e.g., struggling to let go of upsetting thoughts, or over-analyzing situations to the point of distress).
Cognitive Fusion Questionnaire: Instructions
Below you will find a list of statements describing how you might relate to your own thoughts.
Please read each statement carefully and reflect on your own personal experience. Rate how true each statement is for you by circling or selecting the corresponding number next to it.
There are no right or wrong answers. Try not to overthink your responses; your initial instinct is usually the most accurate.
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
Scoring and Interpretation of CFQ results
Calculation:
- Minimum Score: 7 (Indicating high psychological flexibility/low fusion).
- Maximum Score: 49 (Indicating high cognitive fusion).
The CFQ measures a single construct (unidimensional). There isn’t a “pass/fail” mark, but research provides general benchmarks:
Higher Scores (28+): Suggest a tendency to be “hooked” by thoughts, treating them as absolute truths or commands rather than just mental events. High fusion is often correlated with higher levels of anxiety, depression, and psychological distress.
Lower Scores (Below 20): Suggest greater defusion—the ability to observe thoughts without being overwhelmed by them or feeling the need to act on them.
Clinical Utility: A score of 24 or higher is often used in research as a threshold where fusion starts significantly impacting daily functioning and mental well-being.
What does cognitive fusion mean in ACT?
In Acceptance and Commitment Therapy (ACT), cognitive fusion describes the state where an individual becomes completely entangled with their thoughts, treating them as absolute, literal truths rather than passing mental events.
More about cognitive fusion: What is cognitive fusion in ACT?
ACT posits that cognitive fusion is a primary driver of psychological suffering because it traps individuals in rigid patterns of avoidance, pulling them away from a meaningful life. The therapeutic goal is not to eliminate or suppress these difficult thoughts, but to develop “cognitive defusion.”
Defusion creates psychological distance, enabling a person to observe a thought (“I am having the thought that I am a failure”) without being controlled by it, thereby restoring their ability to take action aligned with their core values (Hayes, Strosahl, & Wilson, 2011, Acceptance and Commitment Therapy: The Process and Practice of Mindful Change).
Who developed the Cognitive Fusion Questionnaire?
The Cognitive Fusion Questionnaire (CFQ) was primarily developed by:
David T. Gillanders, University of Edinburgh
Helen Bolderston, University of Southampton
Frank W. Bond, Goldsmiths, University of London
Maria Dempster, Royal Cornhill Hospital
Paul E. Flaxman, City University London
Lindsey Campbell, Royal Cornhill Hospital
Sian Kerr, Royal Cornhill Hospital
Louise Tansey, Royal Edinburgh Hospital
Penelope Noel, Clinical Psychology, Dundee
Clive Ferenbach, Cameron Hospital, Leven
Samantha Masley, Royal Cornhill Hospital
Louise Roach, University of Edinburgh
Joda Lloyd, Goldsmiths, University of London
Lauraine May, Goldsmiths, University of London
Susan Clarke, Bournemouth University
Bob Remington, University of Southampton
Is the CFQ free to use for clinical practice?
Yes, CFQ is completely free to use for both clinical practice and research purposes.
According to the Association for Contextual Behavioral Science (ACBS) and the lead developer, Dr. David Gillanders, mental health professionals do not need to seek special permission, pay licensing fees, or purchase proprietary manuals to administer the assessment to their clients.
This open-access approach was an intentional choice by the research team to ensure that evidence-based Acceptance and Commitment Therapy (ACT) tools remain highly accessible to therapists and patients worldwide.
Official CFQ publication: Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., Masley, S., Roach, L., Lloyd, J., May, L., Clarke, S., Remington, R. (2014) The development and initial validation of The Cognitive Fusion Questionnaire. Behavior Therapy, 45, 83-101, DOI: 10.1016/j.beth.2013.09.001
Author:
Dmytro Shevchenko – Master of Psychology (2011), psychotherapist and ACT-therapy specialist with over 14 years of practice. A member of the APA and ACBS, he has focused on Acceptance and Commitment Therapy since 2018 to help clients build flexible, values-driven lives.