By Hunter King MA MEd Lauren Martone MA Agenda First order change vs Second order change Context surrounding each shift Third wave behavior therapies Dialectical Behavior Therapy DBT ID: 912415
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Slide1
Waves of Behavior Therapy
By:
Hunter King, M.A., M.Ed.
Lauren Martone, M.A.
Slide2Agenda
First order change vs. Second order change
Context surrounding each shift
Third wave behavior therapies
Dialectical Behavior Therapy (DBT)
Acceptance and Commitment Therapy (ACT
Mindfulness-based Cognitive Therapy (MBCT)
Practical differences between third and second waves therapies
Slide3First Order Change Form and Frequency
Second Order Change
Function / Purpose
Slide4FormPurpose
Effective?
Practical Joke
Function
Art
Learning
Slide5Thought:“If I don't practice every day, I will fail.”Form
Function
Work/life balance
Anxiety
Relations
What about…
Increased Pay
Job Status
Positive Feedback
Slide6First WaVE BEHAVIOR THERAPY: 1940-1950sAlternative to psychodynamic approachBehavioral principles:Operant conditioningRespondent conditioningContingency managementExposure and response preventionSystematic desensitization
Focus on:
Discrete behaviorsInpatient adults with severe mental illnessChildren with anxiety, skill deficits, or behavioral concerns
Slide7The shift…
Slide8SEcond
WaVE BEHAVIOR THERAPY: 1960s-1980s
“…techniques designed to modify the dysfunctional beliefs and faulty information processing characteristic of each disorder.” (Beck, 1993, p. 194).
Slide9Similarities and Differences Between 1st and 2nd waves
Form and Frequency
Language and Cognition
Slide10The Shift…
(Gorton et al., 1998; Dobson et al., 2000;
Ilardi & Craighead, 1994; Jacobson et al., 1996; Zettle & Hayes, 1987)
Slide11Third Wave Behavior Therapy: 1980
s
…
Merging with existing theoriesHumanism; ConstructivismBig ideaSecond order changeOngoing act in process
Context and function vs. form
Acceptance and Commitment Therapy (ACT)
Dialectical Behavior Therapy (DBT)
Mindfulness-based Cognitive Therapy (MBCT)
Functional Analytical Psychotherapy (FAP)
Slide12Similarities and Differences between 2nd and 3rd wave
Language and Cognition
Function
vs. Form and Frequency
Slide13Dialectical Behavior Therapy (DBT)Dialectics Opposites can be integrated to form a closer approximation of the truthExample: Teacher with disruptive classroomDoing the best I can BUT/AND I want to do betterSuicide and Borderline PD
Sole use of change-based strategies unhelpfulAcceptance & change strategies were the key
Linehan, 1993
Slide14Mindfulness-based cognitive therapy (MBCT)Prevention of depression relapseCombination of CBT and mindfulnessFocus on awareness of and relationship to thoughts, feelings, and sensationsMindfulness and present moment awarenessNon-judgmental
Negative Thinking
(episode)
Therapy /Coping strategy (Examine/evaluate thoughts; remission)
Potential Relapse(low mood reactivation)
Relapse
(negative thinking re-established)
No Relapse (thinking pattern nipped in the bud)
Slide15Acceptance and commitment therapy
A-C-T
Goal is psychological flexibility
Behavioral component: taking action according to your core values
A life without suffering does not exist
Slide16Act strategies and ideas
Slide17CBTACT
Biased information processing and maladaptive beliefs
Psychological inflexibility
Theory
Identify, evaluate, & modify distorted cognitions
Defusion, acceptance, willingness, commitment, values
Therapy
Cognitive change
Psychological flexibility
Mechanism
Symptom free
Living valued life
Health
Adapted from O'Donohue & Fisher, 2009
Slide18Application TO generalized Anxiety Disorder (GAD)
Slide19Replace avoidance behaviors
Flexible and adaptive responding
CBT
ACT
Therapy
Slide20Therapist as “coach”
“Swimming in same stream”
CBT
ACT
Therapist
Slide21Change content and/or frequency
Distance from private experiences
CBT
ACT
Thoughts and emotions
Slide22Eliminate automatic internal response
Reduce experiential avoidance
CBT
ACT
Goals
Slide23Socratic questioning, empirical tests, persuasion
Metaphors, role play, experiential exercises
CBT
ACT
strategies
Slide24metaphorsPerson & HammerBeach Ball
Slide25“I used to think my mind was my most important organ, until I noticed what was telling me that”- Emo Philips
Slide26Contact us for references / Further ReadingHunter kingEmail: hunter.king@utah.eduLauren MartoneLauren.martone@utah.edu