By Erin Heath, New Harbinger Publications Blog Editor
The Association for Behavioral and Cognitive Therapies (ABCT) Annual Convention is a four-day conference devoted to bringing the cognitive behavioral community together to “stimulate thinking about the myriad issues that surround cognitive behavioral therapy (CBT) and how it intersects with other disciplines,” as the organization puts it. New Harbinger staff have returned to our Oakland office, letting the experience of the conference sink in.
The goal of psychotherapy should be to increase a client’s psychological flexibility. When it comes to clients with emotion regulation disorders, research shows that experiential avoidance and distress intolerance are the two transdiagnostic factors that are responsible for much of the inflexibility that they experience.
Everybody worries, but some people have more than their share. Their peace of mind is often disrupted by “what if?” thoughts of bad possibilities. They recognize that worries are repetitive and unrealistic, but when they try to stop worrying, it gets worse rather than better!
When working with people with psychosis, a compassionate approach is critical, given the high rates of trauma history and the trauma that can be experienced as a result of psychosis symptoms. In some cases, the treatment of psychosis itself can even be traumatizing (for example, being brought into treatment involuntarily by the police).
It’s not exactly news that mindfulness-based therapies are effective. A recent meta-analysis including 209 published empirical outcome studies indicated that mindfulness-based treatments in general were effective in treating a variety of psychological disorders, and as effective as cognitive behavior therapy and pharmacological treatments in the nine studies in which they were compared (Khoury et al., 2013).
Across the board of contemporary psychotherapy modalities, some iteration of defusion-like techniques have been incorporated successfully to yield behavioral change. But when it comes to cognitive behavioral therapy, defusion and cognitive restructuring appear to be very much at odds: the latter assumes that thoughts must change for behavior to change, while the former assumes that thought change doesn’t matter.
When it comes to treatment for psychosis, CBT and acceptance- and mindfulness-based approaches have, at times, been assumed to be incongruent with respect to the goals of “control” and “change.” However, in their integration these approaches can complement one another by emphasizing the understanding, exploration, observation, and acceptance of thoughts and feelings rather than the “stopping” and “controlling” of unwanted thoughts and feelings.