About
What is meant by “
Third Wave
?”
The “first wave” of behavioral therapies were characterized by behaviorism (i.e., operant conditioning, classical conditioning). Albert Ellis and Aaron Beck pioneered the “second wave” of behavioral therapies with cognitive behavioral therapy (CBT), which integrated a person’s thoughts and beliefs in understanding and changing behavior and emotional experiences such as depression.
“Third wave” cognitive behavioral therapies are a group of emerging approaches to psychotherapy that represent an evolution and extension of traditional cognitive behavioral treatment approaches. Third wave therapies prioritize the holistic promotion of psychological and behavioral processes associated with health and well-being over the reduction or elimination of psychological and emotional symptoms, although that typically is a “side-benefit.” Concepts such as metacognition, acceptance, mindfulness, personal values, and spirituality are frequently incorporated into what might otherwise be considered traditional behavioral interventions. Rather than focusing on the content of a person’s thoughts and internal experiences, third wave behavioral therapists are instead more focused on the context, processes, and functions of how a person relates to internal experiences (i.e., thoughts, urges, sensations). Many of the strategies and interventions utilized in third wave cognitive behavioral therapies complement traditional cognitive behavioral interventions such as exposure therapy (e.g., systematic desensitization) and behavioral activation.
Trauma-focused cognitive behavioral therapy (TF-CBT) addresses the mental health needs of children, adolescents, and families suffering from the destructive effects of early trauma. The treatment is particularly sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from sexual abuse, as well as from physical abuse, violence, or grief. Because the client is usually a child, TF-CBT often brings non-offending parents or other caregivers into treatment and incorporates principles of family therapy.
The trauma-focused approach to therapy was first developed in the 1990s by psychiatrist Judith Cohen and psychologists Esther Deblinger and Anthony Mannarino, whose original intent was to better serve children and adolescents who had experienced sexual abuse. TF-CBT has expanded over the years to include services for youths who have experienced many forms of severe trauma or abuse.
1. Somers J, Queree M. Cognitive Behavioural Therapy. Core Information Document. Vancouver: Centre for Applied Research in Mental Health and Addictions (CARMHA); 2007. Tersedia di : https://www.sfu.ca/carmha/publications/cognitive-behavioural-therapy-cbt-core-information.html]
2. Rector NA. Cognitive-behavioural therapy: An information guide. Toronto: Centre for Addiction and Mental Health; 2010. Tersedia di: http://www.imhlk.com/wp-content/uploads/2018/01/CBT_An_Information_Guide.pdf
4. Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT 2013;6:579–85. Tersedia di: https://journals.sagepub.com/doi/full/10.1177/1755738012471029
9. Chawathey K, Ford A. Cognitive behavioural therapy. InnovAiT 2016;9:518–23. Tersedia di: https://journals.sagepub.com/doi/10.1177/1755738016647752?icid=int.sj-full-text.similar-articles.1
10. Morrison AP. A manualised treatment protocol to guide delivery of evidence-based cognitive therapy for people with distressing psychosis: learning from clinical trials. Psychosis 2017;9:271–81. Tersedia di: https://www.tandfonline.com/doi/full/10.1080/17522439.2017.1295098
11. Basco MR, Rush AJ. Cognitive-behavioral therapy for bipolar disorder. 2nd ed. New York: Guilford Press; 2005.
It is believed that changing your thoughts about pain can change how your body responds to pain.
You may not be able to stop physical pain from happening. But, with practice, you can control how your mind manages the pain. An example is changing a negative thought, such as “I cannot do anything anymore,” to a more positive thought, such as “I dealt with this before and I can do it again.”
A therapist using CBT will help you learn to:
- Identify negative thoughts
- Stop negative thoughts
- Practice using positive thoughts
- Develop healthy thinking
Healthy thinking involves positive thoughts and calming your mind and body by using techniques such as yoga, massage, or imagery. Healthy thinking makes you feel better, and feeling better reduces pain.
CBT can also teach you to become more active. This is important because regular, low-impact exercise, such as walking and swimming, can help reduce and prevent back pain over the long run.
For CBT to help reduce pain, your treatment goals need to be realistic and your treatment should be done in steps. For example, your goals may be to see friends more and start exercising. It is realistic to see one or two friends at first and take short walks, maybe just down the block. It is not realistic to reconnect with all of your friends all at once and walk 3 miles (5 kilometers) at once on your first outing. Exercise can help you to deal with chronic pain issues.
