Presented by Pradeep Muthaiya PhD Fulltime Guest Faculty University of Madras Department of Counseling Psychology OUTLINE Third wave psychotherapies THIRD WAVE PSYCHOTHERAPIES ID: 931838
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Slide1
PAPER I- THEORY & PRACTICE OF COUNSELING AND PSYCHOTHERAPY-II
Slide2Presented by
Pradeep
Muthaiya
Ph.D
Full-time Guest Faculty
University of Madras
Department of Counseling Psychology
Slide3OUTLINE
Third wave psychotherapies
Slide4THIRD WAVE PSYCHOTHERAPIES
Dialectical behavior therapy,
Acceptance and commitment therapy,
Mindfulness based cognitive- behavioral therapies
Slide5DIALECTICAL BEHAVIOR THERAPY
Developed by Marcia
Linehan
(1993) and her colleagues
DBT is a behavioral therapy primarily used for highly suicidal individuals diagnosed with borderline personality disorder
Focus on building a life worth living
Slide6DBT
Suicidal behavior is viewed as a maladaptive problem solving behavior
Emphasizes – validation of the client, therapeutic relationship, the etiologic experience of the client with an invalidating environment and confrontation of resistance.
Treatment – mindfulness, acceptance and change strategies
Helps client make changes in behavior, environment, and acceptance of current state
Slide7DBT
Treatment duration – minimum of 1 year
Individual therapy + skills training (group based)
Uses – CBT, BT, and exposure therapy
Client learns to tolerate painful emotions without self-destructive behaviors
Slide8What is dialectics? Teaches clients to recognize and accept simultaneous and opposing forces
Finding a balance between the opposing
forces
Slide9Mindfulness techniques Being aware of the present
Seeing reality without distortion
Seeing reality without judgment
Letting go attachment that cause suffering
Developing acceptance of self and others
Slide10DBT skills training
Provided weekly for 2
hours
Skills are taught in four modules
Mindfulness
Interpersonal effectiveness,
Distress tolerance and
Emotion regulation
Slide11Mindfulness Teaches clients to be aware and accept the world
Clients embrace and tolerate the intense emotions
Slide12Interpersonal effectiveness Clients learn to ask what they need and how to say NO
Learn assertiveness skills
Have and maintain meaningful relationships
Slide13Emotion regulation Identifying emotions
Identifying obstacles to changing emotions
Reducing vulnerability
Increasing positive emotions
Slide14Distress tolerance Help to calmly recognize negative emotions
Learn to tolerate pain or discomfort with skill
Control impulses
Slide15Biosocial Theory
Emotion
dysregulation
– biological factors such as genetics and early life trauma
Environment is invalidating – individual’s emotional responses is viewed as inappropriate, incorrect, pathological and not taken seriously
Punishment of negative emotional responses from childhood
Childhood sexual abuse is also invalidating environment
Emotion
dysregulation
– interferes with problem solving
Slide16Stages and targets of treatment
Stage 1 – Pretreatment
Client and therapist –make a verbal commitment
Agreement to provide best treatment possible
Therapist participates in consultation and follows ethics
First work on life threatening behaviors, therapy interfering behaviors etc
.
Slide17Stages and targets of treatment Stage 2 – have non-traumatizing emotional experience with environment and have meaningful
relationships
Stage 3 – synthesis what is learned, self-efficacy, sense of morality, increase self-respect, mastery, and better quality of life
Slide18Stages and targets of treatment Stage 4
– focuses o
n a
sense of incompleteness, spiritual fulfillment
Slide19Mindfulness-Based Stress Reduction (MBSR)
Developed by Jon
Kabat-Zinn
in 1979
At the University of Massachusetts
Was initially created to help individuals relieve pain
It is an 8 week structured group program
MBSR is not psychotherapy but an adjunct therapy
Slide20MBSR framework
Cause of
Distress
– we continuously
want
things to be different from what it actually is
Mindfulness helps
people live in the present
This approach does not teach active cognitive modification
Slide21MBSR components
Consists of cultivation of non-judgmental attitude
Develop capacity for sustained directed attention through meditation
Emphasis on experiential learning and self-discovery
Skills taught – sitting meditation and mindful yoga
Body scan meditation – observe all sensations in the body
Bring mindfulness to all daily activities
Practice meditation for 45 minutes daily
Clients are taught to positively relate to internal and external stress
Overall developing a mindful way to living
.
Slide22MBSR applicationTaught in schools, hospitals, clinics, corporate offices, prisons
Helps cope with stress, anxiety, depression, attention deficits
Promotes physical and psychological well-being
Slide23Mindfulness-Based Cognitive Therapy (MBCT)
This program is a comprehensive treatment of depression that uses mindfulness+ CBT
MBCT – 8-week group treatment for 2 hours each week
Adapted from MBSR program
Aim – to change awareness and ways of relating to negative thoughts
Slide24MBCT components
Kindness and self-compassion – essential components
Mindfulness
helps
build self-compassion
Form
of self-care
Focus on moment-to-moment experience and develop an attitude of open awareness and accepting
People with self-compassion recognize their suffering and are kind to themselves
Associated with greater wisdom and
intelligence
Slide25Mindful meditation Enhances the ability to concentrate and pay attention
Attending to present experience – develops compassion to self and others
Discard judgment and self-criticism
Slide26Essence of MBCT program
Session 1 – identifying negative automatic thoughts and introduction of basic mindfulness practices
Session 2 – learn about their reactions to life experiences
Learn
about kindness and self-compassion to self and others
Session 3 – focused on gathering the scattered mind
learn
breathing techniques
Session 4 – learning to experience the moment without attachment to outcome
Practice
sitting meditation and mindful walking
Slide27Essence of MBCT program
Session 5 – accepting experiences without holding on
Learn
value of allowing and letting be
Session 6 – view thoughts as merely thoughts not facts
Do
not act on your thoughts
Session 7 – learn to take care of self and develop action plan for relapse
Session 8 – maintaining and sustaining new learning
Generalize
mindfulness practice to daily life
Slide28Acceptance and Commitment Therapy (ACT)
Developed
by Steven C. Hayes
Ph.D. and colleagues
Empirically based psychological intervention – uses acceptance and mindfulness strategies together with commitment and behavior change strategies
Involves fully accepting present experience and mindfully letting go obstacles
Active non-judgmental acceptance of present experience
To create a rich and meaningful life and accepting the pain and challenges that goes with it
Slide29Goals of ACT
Increase psychological flexibility
Flexibility – the ability to be in the present moment and accept the life events fully and without need to change one’s thoughts and behaviors
Take action based on our values
We develop a sense of meaning and purpose
Slide30Six core processes in ACT
Contact with present moment – conscious awareness of the present moments enables accurate understanding of what is happening
Cognitive diffusion – learning to step back from our thoughts
Allow
our thoughts to come and go without getting involved in them
Slide31Six core processes in ACTAcceptance – being open to painful thoughts, emotions or feelings without resistance or fighting with them
Self as context – observing self, which is awareness of awareness
Slide32Six core processes in ACTValues – desired qualities or chosen life direction. What we want to be
Committed action – taking effective action based on our values
Slide33Mindfulness Consciously bringing awareness to the present moment with openness, interest and receptiveness
Mindfulness = Acceptance =Willingness
Slide34Experiential avoidance Consciously bringing awareness to the present moment with openness, interest and receptiveness
Mindfulness = Acceptance =Willingness