Psychological Therapies & Treatments
Acceptance and Commitment Therapy (ACT): Based on a contextual theory of language and cognition known as relational frame theory. It makes use of a number of therapeutic strategies, many of which are borrowed from other approaches, including CBT. However, ACT focuses on the context and function of psychological experiences (e.g., thoughts, feelings, and sensations) as the target of interventions, rather than on the actual form or frequency of particular symptoms. In ACT, individuals increase their acceptance of the full range of subjective experiences, including distressing thoughts, beliefs, sensations, and feelings in an effort to promote desired behaviour change that will lead to improved quality of life. A key principle is that attempts to control unwanted subjective experiences (e.g., anxiety) are often not only ineffective but even counterproductive in that they can result in a net increase in distress, result in significant psychological costs, or both. Consequently, individuals are encouraged to connect with their experiences fully and without defence while moving toward valued goals. ACT also helps individuals to identify their values and translate them into specific behavioural goals.
Behavioral Therapy: Seeks to identify and help change potentially self-destructive or unhealthy behaviors. It functions on the idea that all behaviors are learned and that unhealthy behaviors can be changed. Often combined with cognitive therapy (i.e., Cognitive Behavioural Therapy).
Behavioural Activation: Planning and increasing pleasant activities in your life, as well as activities that result in a sense of mastery and achievement.
Cognitive behaviour therapy (CBT): Combines behavioral therapy with cognitive therapy. Treatment is centered around how someone’s thoughts and beliefs influence their actions and moods. It often focuses on a person’s current problems and how to solve them. The long-term goal is to change a person’s thinking and behavioral patterns to healthier ones. CBT is a focused approach based on the premise that cognitions influence feelings and behaviours, and that subsequent behaviours and emotions can influence cognitions. The clinician works with individuals to identify unhelpful thoughts, emotions, and behaviours. CBT has two aspects: behaviour therapy and cognitive therapy. Behaviour therapy is based on the theory that behaviour is learned and therefore can be changed. Examples of behavioural techniques include exposure, activity scheduling, relaxation, and behaviour modification. Cognitive therapy is based on the theory that distressing emotions and maladaptive behaviours are the result of faulty patterns of thinking. Therefore, therapeutic interventions such as cognitive restructuring and self-instructional training are aimed at replacing dysfunctional thoughts with more helpful cognitions, which leads to an alleviation of problem thoughts, emotions, and behaviour. In this review, metacognitive therapy has been included as part of CBT. Skills training (e.g., stress management, social skills training, parent training, and anger management) is another important component of CBT.
Dialectical Behaviour Therapy (DBT): Dialectical Behaviour Therapy (DBT) is designed to serve five functions: enhance capabilities, increase motivation, enhance generalisation to the natural environment, structure the environment, and improve clinician capabilities and motivation to treat effectively. The overall goal is the reduction of ineffective action tendencies linked with deregulated emotions. It is delivered in four modes of therapy. The first mode involves a traditional didactic relationship with the clinician. The second mode is skills training which involves teaching the four basic DBT skills of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Skills generalisation is the third mode of therapy in which the focus is on helping the individual to integrate the skills learnt into real-life situations. The fourth mode of therapy is team consultation, which is designed to support clinicians working with difficult clients.
Forgiveness Interventions: The two most prominent forgiveness interventions are:
1) Enright's forgiveness therapy process model: a 20-step system to move people through four phases: uncovering one's negative feelings about the offense, deciding to forgive, working toward understanding the offending person, and discovering empathy and compassion for him or her (see Enright, R. D., & The Human Development Study Group (1996). Counseling within the forgiveness triad: On forgiving, receiving forgiveness, and self-forgiveness. Counseling and Values, 40, 107-146).
2) Worthington's REACH Forgiveness model: a five-step process that helps people address their hurt, find empathy for the person who hurt them, reach forgiveness and hold onto that forgiveness over time (see Worthington, E. L. Jr. (2001). Five steps to forgiveness: The art and science of forgiving. New York, NY: Crown).
Mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR): are treatments that emphasise mindfulness meditation as the primary therapeutic technique. MBCT and MBSR are used to interrupt patterns of ruminative cognitive-affective processing that can lead to depressive relapse. In MBCT and MBSR, the emphasis is on changing the relationship to thoughts, rather than challenging them. The aim is to raise awareness at a metacognitive level so that an individual can fully experience cognitions and emotions that pass through the mind that may or may not be based on reality. The goal is not to change the dysfunctional thoughts but to experience them as being real in the present time and separate from the self.
Psychoeducation: involves the provision and explanation of information to clients about what is widely known about characteristics of their diagnosis. Individuals often require specific information about their diagnosis, such as the meaning of specific symptoms and what is known about the causes, consequences, and implications of the problem. Information is also provided about medications, prognosis, and alleviating and aggravating variables, as well as early signs of relapse and how these signs can be actively monitored and effectively managed. Individuals are helped to understand their disorder to enhance their therapy and assist them to live more productive and fulfilling lives.