Food for thought and discussion...

[conky124]

Recently had these thoughts and would like to invite feedback.

1. CBT is to ACT as PC is to Macintosh.

You can do the same things in ACT through a Beck CBT conceptualization, but ACT is a little more user friendly and prettier on the surface.

Also, another thought from working at the VA.

2. Marines are basically pirates, their boot camp and training is pirate school and they all kind of act like swashbuckling pirates. A social worker Marine Vet I worked with giggled and heavily agreed with me when I ran it by him. Thoughts??

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[Mama Bear]

Recently had these thoughts and would like to invite feedback.

1. CBT is to ACT as PC is to Macintosh.

You can do the same things in ACT through a Beck CBT conceptualization, but ACT is a little more user friendly and prettier on the surface.

Also, another thought from working at the VA.

2. Marines are basically pirates, their boot camp and training is pirate school and they all kind of act like swashbuckling pirates. A social worker Marine Vet I worked with giggled and heavily agreed with me when I ran it by him. Thoughts??

1. No, CBT is an umbrella term. CBT is to ACT as computers are to Macintosh.

 

[conky124]

1. No, CBT is an umbrella term. CBT is to ACT as computers are to Macintosh.

I realize it can be used as an umbrella term. That's why I specified "Beck's CBT model". I'm referring to his model/manual specifically that is also referred to as a second wave behavior therapy. Also hardcore ACT people love to say their model is completely different from Beck's CBT. Im trying to point out that it is not once you get past the surface.

 

[beginner2011]

I realize it can be used as an umbrella term. That's why I specified "Beck's CBT model". I'm referring to his model/manual specifically that is also referred to as a second wave behavior therapy. Also hardcore ACT people love to say their model is completely different from Beck's CBT. Im trying to point out that it is not once you get past the surface.

I had a candid conversation with a trainee of one of the ACT figureheads who told me that their mentor considered ACT simply a form of CBT. I've had minimal training in ACT, but a lot of the psychotherapy-related reading I do and individual supervision I'm pursuing is to improve my skill in practicing ACT. For what it's worth, it seems to me to be theoretically defined by CBT and in practice quite different. I think the CBT=computer and ACT=Mac analogy is a good fit.

In the same way a Mac user in the 2020s might look at a computer from the 80s and say "that's nothing I recognize," someone with a limited knowledge-base in CBT might not recognize that, for example, the ACT matrix is essentially a paradigm for behavior therapy. The focus on reducing automaticity of avoidant behaviors (i.e., "away moves") is controlled by contact with aversive stimuli (i.e., "hooks"), and increased contact with appetitive stimuli (i.e., "values") strengthens approach behaviors (i.e., "toward moves"). Increased psychological flexibility is essentially the outcome of cognitive therapy, ACT just has some novel methods to accomplish changes in thinking (defusion, self-as-context). I'd be surprised if a cognitive therapist claimed that good cognitive restructuring made thoughts literally go away and never return.

At least that's my read. I certainly have more to learn.

 

[cara susanna]

I think ACT looks simple and user-friendly on paper, but when you really dig into it is way more complex than Beck's CBT. I teach an ACT seminar to psychiatry residents and even MH professionals like themselves give me blank stares when I discuss relational frame theory.

Then again, maybe that does make it like Mac because I personally do not find their software more user-friendly.

 

[futureapppsy2]

Many, many ABA folks argue that ACT is pure ABA, no “C” about it.

 

[conky124]

Many, many ABA folks argue that ACT is pure ABA, no “C” about it.

My clinical program was all about ACT and some professors at my program would argue there argued this point. To me, I don't see how one can call cognitive defusion, self-as-context, and even mindfulness to be purely behavioral techniques that are not cognitive. I know most probably don't assert that, but I had professors that did. These people also claimed that CBT (w2) teaching people to evaluate their thoughts as "good or bad" and that ACT teaches people to evaluate thoughts as functional or not functional which sounds a lot like Beck's wording of adaptive and maladaptive...

 

[ClinicalABA]

Many, many ABA folks argue that ACT is pure ABA, no “C” about

Reminds me of the good old days when ABCT was AABT.
Many of those same ABA folks would also argue that the effective parts of Beck's CBT relies on derived stimulus relationships, and that the "C" follows the same rules as the "B." Afterall, contrary to popular belief, Skinner did not ignore private behaviors.

 

[conky124]

I had a candid conversation with a trainee of one of the ACT figureheads who told me that their mentor considered ACT simply a form of CBT. I've had minimal training in ACT, but a lot of the psychotherapy-related reading I do and individual supervision I'm pursuing is to improve my skill in practicing ACT. For what it's worth, it seems to me to be theoretically defined by CBT and in practice quite different. I think the CBT=computer and ACT=Mac analogy is a good fit.

In the same way a Mac user in the 2020s might look at a computer from the 80s and say "that's nothing I recognize," someone with a limited knowledge-base in CBT might not recognize that, for example, the ACT matrix is essentially a paradigm for behavior therapy. The focus on reducing automaticity of avoidant behaviors (i.e., "away moves") is controlled by contact with aversive stimuli (i.e., "hooks"), and increased contact with appetitive stimuli (i.e., "values") strengthens approach behaviors (i.e., "toward moves"). Increased psychological flexibility is essentially the outcome of cognitive therapy, ACT just has some novel methods to accomplish changes in thinking (defusion, self-as-context). I'd be surprised if a cognitive therapist claimed that good cognitive restructuring made thoughts literally go away and never return.

At least that's my read. I certainly have more to learn.

I have been primarily trained in ACT at my clinical program and at first it seems complex, but to me it really isn't. They lean pretty hard on relational frame theory to make it seem complex, but to me relational frame theory is actually simple concept with a lot of jargon. It's as if Steven Hayes is the first person to consider behavior and thought within a context, he's definitely not by a long shot.

 

[ClinicalABA]

Recently had these thoughts and would like to invite feedback.

1. CBT is to ACT as PC is to Macintosh.
...

How about CBT is to ACT as Julian is to Ricky?

 

[conky124]

Reminds me of the good old days when ABCT was AABT.
Many of those same ABA folks would also argue that the effective parts of Beck's CBT relies on derived stimulus relationships, and that the "C" follows the same rules as the "B." Afterall, contrary to popular belief, Skinner did not ignore private behaviors.

Right but I counter, what isn't a behavior then? It seems that radical behaviorists rely on calling everything a behavior and then relying on circular reasoning. That being said I am a behaviorist, but I am critical of it.

 

[conky124]

How about CBT is to ACT as Julian is to Ricky?

Ricky sure knows how to out smart cops so...

also very glad you recognized the reference from my avatar!

 

[ClinicalABA]

Right but I counter, what isn't a behavior then? It seems that radical behaviorists rely on calling everything a behavior and then relying on circular reasoning. That being said I am a behaviorist, but I am critical of it.

If looks like duck, smells like duck, responds to environmental stimulus-consequence relationships like a duck, and can be elicited by a CS like a duck, it's probably a duck! No circular reasoning necessary.

 

[conky124]

If looks like duck, smells like duck, responds to environmental stimulus-consequence relationships like a duck, and can be elicited by a CS like a duck, it's probably a duck! No circular reasoning necessary.

Joke's on you it turned out to be a loon

 

[foreverbull]

ACT is Zen Buddhism with relational frame theory to give it a non-religion spin. Psychologists love to blend pieces of other theories/philosophies and maybe add a tiny element and then us a new title and new buzz words so that they can claim it’s theirs and it’s scientific. Hayes is no different—but I’m still a fan of ACT.

Specifically with ACT, I find that it can go over some people’s heads when I start using metaphors or going into the nitty-gritty of acceptance of thoughts and cognitive defusion rationale and techniques. Some people don’t get into it. Some do and love it. To me, ACT is like another step above CBT in terms of how it addresses thoughts and how abstract it can get beyond traditional CBT. Some people need to start small and use evidence and challenging irrational thoughts and replacing them with more reasonable or compassionate thoughts before they can get to the stage of just accepting thoughts as just meaningless chatter and letting them go and fully defusing. Some folks may not ever want to go that far or it may not appeal to them, however, and benefit from traditional CBT.

In my opinion, people who respond best to ACT already have a life philosophy that is pretty congruent with Zen—being in the moment and acceptance of emotions and the general flow of life. That already sets you up to de-identify with your thoughts and be more objective.

Some aspects, however, are useful to all, like the exploration of values/meaning and experiential avoidance, etc. I find that many people benefit from exploring those aspects even if the cognitive piece is not something they relate to.

 

[conky124]

ACT is Zen Buddhism with relational frame theory to give it a non-religion spin. Psychologists love to blend pieces of other theories/philosophies and maybe add a tiny element and then us a new title and new buzz words so that they can claim it’s theirs and it’s scientific. Hayes is no different—but I’m still a fan of ACT.

Specifically with ACT, I find that it can go over some people’s heads when I start using metaphors or going into the nitty-gritty of acceptance of thoughts and cognitive defusion rationale and techniques. Some people don’t get into it. Some do and love it. To me, ACT is like another step above CBT in terms of how it addresses thoughts and how abstract it can get beyond traditional CBT. Some people need to start small and use evidence and challenging irrational thoughts and replacing them with more reasonable or compassionate thoughts before they can get to the stage of just accepting thoughts as just meaningless chatter and letting them go and fully defusing. Some folks may not ever want to go that far or it may not appeal to them, however, and benefit from traditional CBT.

In my opinion, people who respond best to ACT already have a life philosophy that is pretty congruent with Zen—being in the moment and acceptance of emotions and the general flow of life. That already sets you up to de-identify with your thoughts and be more objective.

Some aspects, however, are useful to all, like the exploration of values/meaning and experiential avoidance, etc. I find that many people benefit from exploring those aspects even if the cognitive piece is not something they relate to.

Couldn't agree with you more, especially the part about how some clients need to build a foundation of replacing maladaptive thoughts. I'll add that in my experience as a fledgling psychologist who has lead some groups, is that some clients who end up using CBT techniques to over analyze their thoughts do well with ACT.

 

[bcliff]

ACT and CT are both forms of CBT -- Behavioral activation is foundational to both .

To greatly over simplify, the key difference between the two is whether the cognitive focus is on changing the content of thoughts (CT) or changing one's relationship with their thoughts (ACT).

 

[AcronymAllergy]

Couldn't agree with you more, especially the part about how some clients need to build a foundation of replacing maladaptive thoughts. I'll add that in my experience as a fledgling psychologist who has lead some groups, is that some clients who end up using CBT techniques to over analyze their thoughts do well with ACT.

This is good to know, as I've had a few trainees experience this with patients. It also inherently makes sense.

I'll say I've also seen, as mentioned above, situations with trainees in which ACT did seem to go over the patient's head.

 

[conky124]

ACT and CT are both forms of CBT -- Behavioral activation is foundational to both.

To greatly over simplify, the key difference between the two is whether the cognitive focus is on changing thoughts (CT) or changing one's relationship with their thoughts (ACT).

Right, but in my opinion to change thoughts you have to change your relationship with them and to change your relationship with thoughts you have to change your thinking ( I.e to observe your thoughts objectively) which you do with Becks CBT.

 

[conky124]

ACT and CT are both forms of CBT -- Behavioral activation is foundational to both .

To greatly over simplify, the key difference between the two is whether the cognitive focus is on changing the content of thoughts (CT) or changing one's relationship with their thoughts (ACT).

Also wasn't behavioral activation developed to be a control therapy for treatment outcome studies of CBT? Its my understanding that this was true and they found BA to be just as effective.

 

[bcliff]

Right, but in my opinion to change thoughts you have to change your relationship with them and to change your relationship with thoughts you have to change your thinking ( I.e to observe your thoughts objectively) which you do with Becks CBT.

Acknowledging (or "accepting") negative thoughts (defined broadly) while "committing" to engage in behavioral activation (i.e., committed action, engaging in "valued activities") seems more straightforward to me than acknowledging negative thoughts, *then* changing those negative thoughts, *and then* engaging in behavioral activation -- My understanding is that the utility of the "changing negative thoughts" step hasn't been supported by the dismantling research (link: https://tinyurl.com/yy8wuubw).

FWIW, I've had good outcomes using ACT (and standalone BA) with clients with a wide variety of cognitive difficulties, so I don't necessarily buy into the narrative that ACT is fundamentally "harder to grasp, etc." than more "traditional CBT" (i.e., cognitive therapy) -- I actually find principles of ACT to be particularly useful when working with individuals with static or otherwise unchangeable barriers (e.g., cognitive dysfunction) impeding their experiences of happiness, wellbeing, etc.

I keep mentioning "principles of ACT," because it's often hard for me to differentiate my delivery of standalone BA from a more complete ACT protocol. I'm relying on the same theoretical foundations and principles of behavior change (i.e., see the hexaflex) either way (link: https://tinyurl.com/yyssprcn).

 

[conky124]

Acknowledging (or accepting) negative thoughts (defined broadly) while committing to engage in behavioral activation (i.e., committed action, engaging in "valued activities") seems more straightforward to me than acknowledging negative thoughts, *then* changing those negative thoughts, *and then* engaging in behavioral activation -- My understanding is that the utility of the "changing negative thoughts" step hasn't been supported by the dismantling research (link: https://tinyurl.com/yy8wuubw).

Right, rather than evaluating the thought and coming up with a replacement thought. ACT provides a short cut (and a very useful one) that teaches one to stop analyzing thoughts that aren't helpful in the present moment all together. I argue you can't do this without changing your thinking, its just sticking to one technique of doing so.

Also, what grinds my gears (not saying you are doing this) is that hardcore ACT/radical behaviorists claim that CBT makes one judge all thoughts as good or bad just because CBT teaches you how to recognize a thought that has a negative self-message. They then also claim that the common and well supported heuristics or cognitive distortions CBT teaches clients that their minds are distorted. Its all one weird straw man argument I keep hearing from these individuals.

 

[cara susanna]

Right, rather than evaluating the thought and coming up with a replacement thought. ACT provides a short cut (and a very useful one) that teaches one to stop analyzing thoughts that aren't helpful in the present moment all together. I argue you can't do this without changing your thinking, its just sticking to one technique of doing so.

Also, what grinds my gears (not saying you are doing this) is that hardcore ACT/radical behaviorists claim that CBT makes one judge all thoughts as good or bad just because CBT teaches you how to recognize a thought that has a negative self-message. They then also claim that the common and well supported heuristics or cognitive distortions CBT teaches clients that their minds are distorted. Its all one weird straw man argument I keep hearing from these individuals.

Yeah, I think the more you get into CBT the more you learn that ACT and traditional CBT's approaches to cognitive restructuring are not that different.

 

[bcliff]

Yeah, I think the more you get into CBT the more you learn that ACT and traditional CBT's approaches to cognitive restructuring are not that different.

I'm pretty sure that Hayes completed his postdoc with Barlow, so the similarities make sense.

I first noticed the similarities when reading Barlow's CBT for panic manual -- I think it's important to note that a key difference between the two is that the "acceptance" component of ACT is conceptualized more as an exposure-based intervention, rather than a "cognitive restructuring" intervention.

Also, as an ACT provider, I focus on the function of thoughts, rather than their content -- Assuming that BA is an active ingredient of both CT and ACT, then I'd argue that as soon as a provider starts analyzing the function of their clients' thinking, then they're crossing over into ACT territory.

 

[conky124]

I'm pretty sure that Hayes was Barlow's postdoc, so the similarities make sense -- I first noticed the similarities when reading Barlow's CBT for panic manual.

As an ACT provider, I focus on the function of thoughts, rather than their content -- If BA is an active ingredient of both CT and ACT, then I'd argue that as soon as a provider starts analyzing the function of their clients' thinking, then they're crossing over into ACT territory.

Ok, but doesn't adaptive and maladaptive basically mean functional or not functional? I just think that CBT also relies on functional analysis of thoughts too, but ACT teaches that it doesn't. Maybe I'm wrong

 

[beginner2011]

Ok, but doesn't adaptive and maladaptive basically mean functional or not functional? I just think that CBT also relies on functional analysis of thoughts too, but ACT teaches that it doesn't. Maybe I'm wrong

I certainly see that as a risk. For example, the ABC worksheet in CPT asks the patient, "Are my thoughts above in 'B' realistic?"

All my supervisors have acknowledged that it's appropriate to follow up with "Are my thoughts helpful/useful?" if and when patients get stuck on the idea of "realistic". However, the content as-is certainly lends itself to over-reliance on changing the content of thoughts due to the thought being irrational/unrealistic. I'm curious what Resick would say about that, but even she is not the arbiter of cognitive theory in psychotherapy.

 

[bcliff]

Ok, but doesn't adaptive and maladaptive basically mean functional or not functional? I just think that CBT also relies on functional analysis of thoughts too, but ACT teaches that it doesn't. Maybe I'm wrong

Interesting -- I'm not sure. I'm admittedly not as familiar with CT.

My understanding is that, from a CT perspective, there is an assumption that there *must* be maladaptive thoughts, because those thoughts are considered to be the underlying *cause* of the experiences of distress.

As an ACT provider, I don't make that assumption -- Thoughts are just as likely to impact behavior as any other aspects of an individual's environment (defined broadly).

 

[conky124]

I certainly see that as a risk. For example, the ABC worksheet in CPT asks the patient, "Are my thoughts above in 'B' realistic?"

All my supervisors have acknowledged that it's appropriate to follow up with "Are my thoughts helpful/useful?" if and when patients get stuck on the idea of "realistic". However, the content as-is certainly lends itself to over-reliance on changing the content of thoughts due to the thought being irrational/unrealistic. I'm curious what Resick would say about that, but even she is not the arbiter of cognitive theory in psychotherapy.

Good point, a main difference is that ACT doesn't touch the topic of whether thoughts are realistic or accurate.

OH THE TYRANNY OF LANGUAGE!!!

 

[tr]

They then also claim that the common and well supported heuristics or cognitive distortions CBT teaches clients that their minds are distorted. Its all one weird straw man argument I keep hearing from these individuals.

Isn't there a little bit of truth to this though? I do feel that using the word 'distortion' can sometimes put certain people in a defensive mode ("My thoughts are not distorted!"), and also doesn't apply that well to negative thoughts/fears that do have a basis in reality.

I long ago stopped using the term 'cognitive distortion' (though it is still printed on the handouts, I don't dwell on that) and instead try to invite people to reframe their thoughts more positively in a way that makes sense to them, which could include recognizing a distortion if they agree that is what's going on, but could also include applying Acceptance or deciding on a more productive course of thought or action.

 

[cara susanna]

Interesting -- I'm not sure. I'm admittedly not as familiar with CT.

My understanding is that, from a CT perspective, there is an assumption that there *must* be maladaptive thoughts, because those thoughts are considered to be the underlying *cause* of the experiences of distress.

As an ACT provider, I don't make that assumption -- Thoughts are just as likely to impact behavior as any other aspects of an individual's environment (defined broadly).

Yes, "is my thought helpful?" is a question asked in traditional CBT. For instance, the CPT 2017 manual now includes that on the ABC sheets.

Additionally, if a thought is too "sticky," we are often told to ask "what would it MEAN if this thought were true?" or something like that. I consider that similar to assessing the function of the thought. I think the question of realistic/unrealistic is really basic CBT and, although part of the model, people who are focused only on that are missing the bigger picture.

I do remember that during my CPT training I frustrated the trainer a lot by wanting the patient to just sit with the thought and tolerate the negative emotions it brought. Haha.

 

[bcliff]

Yes, "is my thought helpful?" is a question asked in traditional CBT. For instance, the CPT 2017 manual now includes that on the ABC sheets.

Additionally, if a thought is too "sticky," we are often told to ask "what would it MEAN if this thought were true?" or something like that. I consider that similar to assessing the function of the thought. I think the question of realistic/unrealistic is really basic CBT and, although part of the model, people who are focused only on that are missing the bigger picture.

I do remember that during my CPT training I frustrated the trainer a lot by wanting the patient to just sit with the thought and tolerate the negative emotions it brought. Haha.

Haha, yes -- Why change a thought that is not inherently dangerous? To change it reinforces a narrative that thoughts have some special power that they don't actually have.

 

[conky124]

Isn't there a little bit of truth to this though? I do feel that using the word 'distortion' can sometimes put certain people in a defensive mode ("My thoughts are not distorted!"), and also doesn't apply that well to negative thoughts/fears that do have a basis in reality.

I long ago stopped using the term 'cognitive distortion' (though it is still printed on the handouts, I don't dwell on that) and instead try to invite people to reframe their thoughts more positively in a way that makes sense to them, which could include recognizing a distortion if they agree that is what's going on, but could also include applying Acceptance or deciding on a more productive course of thought or action.

I personally think that some staunch ACT proponents have put a negative spin on it and yes I agree that the word distortion has the potential to be misconstrued. However, cognitive distortions are in fact distortions, but they also come from cognitive heuristics that can be very adaptive in certain contexts. I think its important for clients to know that conclusions based on cognitive distortions can't be true and that this is just the flip side of a useful tool we don't want to get rid of all together.

 

[cara susanna]

I personally think that some staunch ACT proponents have put a negative spin on it and yes I agree that the word distortion has the potential to be misconstrued. However, cognitive distortions are in fact distortions, but they also come from cognitive heuristics that can be very adaptive in certain contexts. I think its important for clients to know that conclusions based on cognitive distortions can't be true and that this is just the flip side of a useful tool we don't want to get rid of all together.

Right - it's about promoting cognitive flexibility. The issue with the thoughts we target in CBT is that they are rigid and extreme.

 

[conky124]

Haha, yes -- Why change a thought that is not inherently dangerous? To change it reinforces a narrative that thoughts have some special power that they don't actually have.

Unless the thought reinforces a non-functional behavior. Radical behaviorists on one hand will claim thoughts are behaviors, then abandon this point to say that changing thoughts are not related to behavior change. Can you have behavior change with out a change in thinking?

 

[cara susanna]

Also, this reminds me of a panel I attended back at ABCT that had Linehan, Hayes, and a traditional CBT guy whose name I don't know sorry discussing traditional CBT vs. third wave CBT. All I remember is that the third wavers' suggestion that an emotion could be a cognition was quite upsetting to the traditional CBT person!

 

[cara susanna]

Unless the thought reinforces a non-functional behavior. Radical behaviorists on one hand will claim thoughts are behaviors, then abandon this point to say that changing thoughts are not related to behavior change. Can you have behavior change with out a change in thinking?

Well, you can still have the thought and engage in the behavior if you acknowledge that the thought isn't necessarily a fact. Honestly, even traditional CBT does this by teaching about emotional reasoning. In the end, changing the behavior can also change the thought because you get more evidence that your thought isn't true.

 

[futureapppsy2]

Reminds me of the good old days when ABCT was AABT.
Many of those same ABA folks would also argue that the effective parts of Beck's CBT relies on derived stimulus relationships, and that the "C" follows the same rules as the "B." Afterall, contrary to popular belief, Skinner did not ignore private behaviors.

I've seen the (to me, cringe-inducing) argument that "BCBAs can practice ACT for mental health issues, even with no training in psychotherapy, because it's ABA, but of course, we can't use CBT, because that's psychotherapy/not behavioral." Ugh, no. Don't practice psychotherapy if you have no training in it.

Fun fact: Some of the psych faculty at WVU have apparently "disowned" Hayes because ACT is "not truly behavioral."

 

[bcliff]

A couple questions...

Does CT emphasize principles of exposure in the same way that ACT does? (I don't think it does)

Does CT not assume that thinking is the root cause of behavior? (I think it does)

This thread has been interesting -- I think those are two of the key factors that differentiate the two for me.

 

[conky124]

I've seen the (to me, cringe-inducing) argument that "BCBAs can practice ACT for mental health issues, even with no training in psychotherapy, because it's ABA, but of course, we can't use CBT, because that's psychotherapy/not behavioral." Ugh, no. Don't practice psychotherapy if you have no training in it.

Fun fact: Some of the psych faculty at WVU have apparently "disowned" Hayes because ACT is "not truly behavioral."

That's surprising. Maybe they are abandoning ACT because it has failed to outperform CBT and they have already taken the stance that "CBT is failing." I assume they are all about FAP (i hear you can go blind from that). At my program students talked about Steven Hayes like he was a spiritual leader or something.

 

[conky124]

A couple questions...

Does CT emphasize principles of exposure in the same way that ACT does? (I don't think it does)

Does CT not assume that thinking is the root cause of behavior? (I think it does)

This thread has been interesting -- I think those are two of the key factors that differentiate the two for me.

I mean, I'd say ACT is different from CT on those points you make, but not CBT necessarily.

 

[bcliff]

I mean, I'd say ACT is different from CT on those points you make, but not CBT necessarily.

CBT is the umbrella, under which CT and ACT exist.

 

[conky124]

CBT is the umbrella, under which CT and ACT exist.

I thought Cognitive Therapy existed before CBT. The complaint from radical behaviorists is that the inclusion cognitive principles (also found in CT) were added to behavior therapy resulting in a "second wave of behavior therapy" or CBT

 

[bcliff]

I thought Cognitive Therapy existed before CBT. The complaint from radical behaviorists is that the inclusion cognitive principles (also found in CT) were added to behavior therapy resulting in a "second wave of behavior therapy" or CBT

My understanding is that the active ingredient of CT has always been BA, with "traditional CBT" being used as a label to more appropriately characterize the intervention.

 

[conky124]

My understanding is that the active ingredient of CT has always been BA, with "traditional CBT" being used as a label to more appropriately characterize the intervention.

Not according to Hayes (2004 in Behavior Therapy) Look at this abstract from "Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies"

"The first wave of behavior therapy countered the excesses and scientific weakness of existing nonempirical clinical traditions through empirically studied first-order change efforts linked to behavioral principles targeting directly relevant clinical targets. The second wave was characterized by similar direct change efforts guided by social learning and cognitive principles that included cognitive in addition to behavioral and emotive targets. Various factors seem to have set the stage for a third wave, including anomalies in the current literature and philosophical changes. Acceptance and Commitment Therapy (ACT) is one of a number of new interventions from both behavioral and cognitive wings that seem to be moving the field in a different direction..."

 

[bcliff]

Not according to Hayes (2004 in Behavior Therapy) Look at this abstract from "Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies"

"The first wave of behavior therapy countered the excesses and scientific weakness of existing nonempirical clinical traditions through empirically studied first-order change efforts linked to behavioral principles targeting directly relevant clinical targets. The second wave was characterized by similar direct change efforts guided by social learning and cognitive principles that included cognitive in addition to behavioral and emotive targets. Various factors seem to have set the stage for a third wave, including anomalies in the current literature and philosophical changes. Acceptance and Commitment Therapy (ACT) is one of a number of new interventions from both behavioral and cognitive wings that seem to be moving the field in a different direction..."

Is CT (or "traditional CBT") not part of that second wave?

 

[conky124]

Is CT (or "traditional CBT") not part of that second wave?

principles from CT existed separately from behavior therapies and the second wave decided to include some of them along with social learning and other emotional stuff.

 

[bcliff]

principles from CT existed separately from behavior therapies and the second wave decided to include some of them along with social learning and other emotional stuff.

I'm using the terminology from this seminal paper that I cited earlier (link: https://tinyurl.com/yy8wuubw).

 

[conky124]

I'm using the terminology from this seminal paper that I cited earlier (link: https://tinyurl.com/yy8wuubw).

So, in that paper it looks like they are breaking down the components of what makes up CBT and testing the cognitive components. Their language is confusing because they actually abbreviate cognitive behavior therapy as CT in their intro. Cognitive therapies did exist before CBT and were added in, that's what I am referring to.

 

[bcliff]

So, in that paper it looks like they are breaking down the components of what makes up CBT and testing the cognitive components. Their language is confusing because they actually abbreviate cognitive behavior therapy as CT in their intro. Cognitive therapies did exist before CBT and were added in, that's what I am referring to.

Do you have examples of those cognitive interventions? I'm not familiar with any cognitive interventions that don't have a behavioral component.

My understanding is that, like I've been doing in this thread, those authors abbreviated "traditional CBT" as CT because that's what it is.

 

[conky124]

Do you have examples of those cognitive interventions? I'm not familiar with any cognitive interventions that don't have a behavioral component.

My understanding is that, like I've been doing in this thread, those authors abbreviated "traditional CBT" as CT because that's what it is.

No I don't, at least not on the top of my head, maybe gestalt therapy? Cognitive theory did exist before CBT. The thing is Hayes and people who subscribe to the waves of behavioral therapy describe the history as behavior therapy plus cognitive theory components to result in CBT. It was my understanding that therapists did use therapies based on the cognitive model before CBT was developed. That doesn't mean that behavioral components weren't involved, but it wasn't Becks classic CBT. Maybe we are getting stuck on terminology. There is a difference between the umbrella term of Cognitive Behavior Therapy and the classic Cognitive Behavior Therapy developed by Beck in the 70's. In that paper they refer to Becks CBT as CT, and I think that is making this a bit confusing.

Do we have a cognitive therapist around???