I’ll continue with another post about psychotherapy. For this post it might be beneficial to read a little about Acceptance and Commitment Therapy and other behavioral therapies to best understand my post. I wrote it assuming that the reader had at least a basic understanding of these therapies.
The first wave of behavior therapy was closely tied to the theories of Skinner and Watson. Second wave treatments added in cognitive components and expanded on basic behaviorism. Third wave models keep many of the good techniques from the first two waves but focus more on contextual behavior than atomistic behavior, flexible skills than pathology, and function than form. Third wave methods emphasize the broad constructs of values, spirituality, relationships, and mindfulness whereas first and second wave therapies are focused mainly on the immediate problems. For example, with second wave behavior therapy, the therapist might seek to challenge and change cognitions but in a third wave therapy the therapist might focus more on understanding and accepting the cognitions and how they tie into a person’s value system (that is not the end goal of third wave therapies – the therapists also seek change but change is effected differently than in second wave therapies). Continue reading “Third Wave Behavior Therapies”
Cognitive behavior therapies (CBT) all have (or should have) the general underlying model of: Activating Event –> Schemas –> Thoughts –> Behavior/Emotions –> Outcome. In other words, there is a specific and precipitating event that is mentally interpreted, thought about, and acted (or not) upon; all of the steps following the precipitating and activating event lead to a consequence, or outcome. More specifically, our thoughts are really the cause of our behaviors and emotions – our behaviors are internally driven, even in the face of powerful external events. In order for this model to work there are a few basic assumptions that serve as the foundation for cognitive-behavior therapy.
One of these assumptions is that cognitions affect and cause behavior. This goes beyond traditional behavior therapy because cognitions serve as mediating responses between the initial stimuli and behavioral responses. So in effect, it is our cognitions that cause behavior because how we interpret events determines how we react to them. Behavior also can affect cognitions but the general point is that cognitions are not only involved in the behavioral process but necessary to it.
Another assumption is that cognitions are not simply mysterious ephemeral processes – they can be measured, monitored, and altered. Asking people how they think and feel is thus a potentially effective way to understand their behavior. If cognitions can be measured they can also be altered. This means that the way that people think about the world and think about themselves can be changed, which is the goal of CBT when there is maladaptive behavior and cognitions.
As cognitions change, behavior may change. CBT does not ignore the role that changing behaviors (separate from cognitions) has in the therapeutic process but it is important to change cognitions to exact lasting behavioral change. Also, cognitive change is important in cases where situations and external influences on behavior do not, cannot, or will not change.
Image by Dinovitch.