Week 9

Question 1

THIRD WAVE THERAPIES

Answer 1

• Acceptance & Commitment Therapy (Hayes)
• Dialectical Behaviour Therapy (Linehan)
• Mindfulness-Based Stress Reduction (Kabat-Zinn)
• Mindfulness-Based Cognitive Therapy (Segal et al)

Question 2

Third Generation CBT

Answer 2

Jon Kabat-Zinn
- Mindfulness Based Stress Reduction program (MBSR)

Segal, Williams and Teasdale
- Mindfulness-Based Cognitive Therapy for Depression (MBCT)

Hayes, Wilson and Strosahl
- Acceptant and Commitment Therapy (ACT)

Marsha Linehan
- Dialectical Behaviour Therapy (DBT)

Question 3

Mindfulness Based Cognitive therapy (MBCT)

Answer 3

Funded to develop a group therapy
program for the prevention of relapse of unipolar depression

To help individuals make a radical shift in their relationships to the thoughts, feelings and bodily sensations that contribute to depressive relapse.

The instructors own basic understanding and orientation will be one of the most powerful influences affecting this process.
MBCT – 8 session group

Question 4

MBCT – 8 session group program

Core Aims:

Answer 4

To help people who have suffered from depression in the past learn skills to help prevent depression coming back.

To become more aware of bodily sensations, feelings and thoughts, from moment to moment.

To help participants develop a different way of relating to sensations, thoughts and feelings.

To help participants be able to choose the most skillful response to any unpleasant thoughts, feelings or situations that they meet.

Question 5

MBCT – 8 session group program

The structure

Answer 5

Sessions 1-4
•First participants become aware of how little attention is usually paid to daily life.
•Second they learn how having noticed the mind is wandering to bring it back to single focus.
•Third they become aware of how this mind wandering can allow negative thoughts and feelings to occur.

Sessions 5-8
•Participants learn whenever a negative thought or feeling arises to allow it to be there before taking steps to respond skillfully to it.

•Finally participants are encouraged to become more aware of their own unique warning signs of impending depression and to develop specific action plans for when
this might occur.

Question 6

MBCT The Evidence Base

Answer 6

Their own three-centre clinical trial randomly allocated 145 participants to an 8 session MBCT group program or to treatment as usual.

The results showed that participants with 3 or more previous episodes of depression had a relapse rate of 37% significantly less than the 66% relapse rate for the group with TAU.

Aps 2018
Level I
Depression

Level II
Generalised Anxiety Disorder, ADHD, Hypochondriasis,

Level III-2
Sexual Disorders

Level IV
Panic Disorder, BPD

Question 7

Acceptance and Commitment Therapy (ACT)

Answer 7

Developed as a reaction to CBT, based on the premise
that controlling thoughts does the person more harm,
whereas acceptance of thoughts defuses their impact.

Question 8

ACT Evidence Based Applications

Answer 8

Affective Disorders
Anxiety Disorders
Posttraumatic Stress Disorder
Substance Abuse and Dependence
The Seriously Mentally Ill (Psychotic Disorders)
Stress
Chronic Pain
Children, Adolescents and Parents
Medical settings
Groups

Level II

• Generalised anxiety disorder,
• Panic disorder
• Social anxiety disorder,
• Obsessive compulsive disorder Borderline personality disorder
• Depression,
• Psychotic disorders
• Hypochondriasis,
• Pain disorder
• Substance use disorder

Level IV
- Binge eating disorder

Question 9

Core ACT Concepts

Answer 9

ACT views the core of many problems to be due to the concepts represented in the acronym, FEAR:

Fusion with your thoughts
Evaluation of experience
Avoidance of your experience
Reason-giving for your behavior

And the healthy alternative is to ACT:

Accept your reactions and be present
Choose a valued direction
Take action

Question 10

ACT aim

Answer 10

To create a rich, full and meaningful life, while accepting the pain that inevitably goes with it.

Question 11

ACT Framework (The Hexaflex)

Answer 11

ACT- Six core processes

1. Contact with the Present Moment
2. Acceptance
3. Defusion (look at your thoughts rather than from them)
4. Self-as-context (the observing self)
5. Values (becoming aware of your values)
6. Committed Action (commit to behaviours that are in line with your values)

Question 12

Personality disorders ICD-10

Answer 12

“an extreme deviation from the way an average person in a particular culture perceives, thinks, feels and relates to others. The disorder involves deeply ingrained and
enduring patterns of behaviour that are manifested as inflexible responses to a wide range of social and personal situations. The disorder may cause distress
to the individual and create problems in social functioning
or performance. “ ICD-10

Question 13

DBT for BPD

Level I evidence

Answer 13

DBT for BPD
Level I
Lynch, Trost, Salisman & Linehan (2007)
Critical review of 8 RCT’s of manualised DBT found DBT was an effective treatment in 7 of the studies conducted across four independent research teams.

Question 14

DBT- Core Components

Answer 14

Essentially CBT that incorporates mindfulness and acceptance

• Balance of validation and change
• Stages and targets
• Individual DBT therapy
• Group skills training
• Peer Consultation
• As needed client/therapist consultation phonecall

Question 15

DBT – Stages and Targets

Answer 15

Stage One:  
Behavioural control
Target 1: life-threatening behaviours
Target 2: Therapy interfering behaviours
Target 3: Behaviours that destroy quality of life
Target 4: Learn skills

Stage Two: Experiencing emotions
Stage Three: Building an ordinary life
Stage Four: Moving from Incompleteness to
Completeness