What is Third Wave Cognitive Behavioral Therapy?


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.

“Grounded in an empirical, principle-focused approach, the third wave of behavioral and cognitive therapy is particularly sensitive to the context and functions of psychological phenomena, not just their form, and thus tends to emphasize contextual and experiential change strategies in addition to more direct and didactic ones. These treatments tend to seek the construction of broad, flexible and effective repertoires over an eliminative approach to narrowly defined problems, and to emphasize the relevance of the issues they examine for clinicians as well as clients. The third wave reformulates and synthesizes previous generations of behavioral and cognitive therapy and carries them forward into questions, issues, and domains previously addressed primarily by other traditions, in hopes of improving both understanding and outcomes.”(from Hayes, 2004).”


ACT is a behaviorally-oriented therapeutic approach that aims to modify how a person relates and responds to their internal experiences (i.e., thoughts, emotions, physical sensations, and urges) in order to more fully engage in values-based behaviors.


DBT is a form of cognitive-behavioral therapy effective in treating intense emotional reactions and relationship difficulties.


Through the practice and application of meditation people learn to cultivate a more mindful approach to experiencing difficult thoughts and emotions in order to develop healthier behavioral patterns.


Metacognitive therapy is shares similarities with the more traditional Cognitive Therapy, but rather than focusing on the content of thought the emphasis is on exploring a person’s thoughts and beliefs surrounding the content of their thoughts (i.e., metacognitions).


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